Next-Generation Stent Technology

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2026 | Volume 2 | Issue 1 | Page 41- 48

1. Dr. M. Ganga, Associate Professor, Department of Cardiology, J. J. Institute of Med. Sci. UAE

2. Dr. Abrahim Ghosh, Professor, Department of Cardiology, M.S. Ramahia M. C. India (Corresponding Author)

Abstract

The evolution of percutaneous coronary intervention (PCI) has been defined by the continuous quest to overcome the biological limitations of the vascular wall. While the transition from Bare-Metal Stents (BMS) to second-generation Drug-Eluting Stents (DES) significantly reduced restenosis rates, the persistence of a permanent metallic "caged" artery remains a concern for long-term vascular physiology. This chapter provides a critical evaluation of Next-Generation Stent Technologies, focusing on the shift from permanent mechanical support to transient bio-adaptive scaffolds. We analyze the latest advancements in Ultra-Thin Strut DES ($< 60$ microns), which have demonstrated superior endothelialization and reduced thrombogenicity in complex lesions. A primary focus is placed on the resurgence of Bioresorbable Vascular Scaffolds (BVS), examining how the "thin-strut" polymer and magnesium-based designs of 2024–2026 have addressed the early safety concerns of late scaffold thrombosis. Furthermore, the discussion explores Drug-Filled Stents (DFS), which eliminate the need for external polymers, and Pro-healing Stents coated with antibodies to accelerate natural vessel repair. The chapter also highlights the role of Nanotechnology in targeted drug delivery and the development of "Smart Stents" capable of wireless pressure monitoring. By synthesizing data from recent multi-center trials, this chapter establishes that the future of stenting lies in "Vascular Restoration"—allowing the artery to regain its natural vasomotion while providing precise, temporary support. This technological leap marks a new era in interventional cardiology, ensuring long-term vessel health beyond simple luminal patency.