Implantation of metal stents
When balloon angioplasty was the only intracoronary treatment option, there were two fundamental problems that reduced the efficacy of percutaneous therapy. One was the acute or sub-acute occlusion of the treated artery, which occurred in 5-7% of treated patients, leading to infarction and the need of a new urgent catheterism or surgery. The other was the incidence of re-stenosis of the treated plaque, either due to adverse vascular remodelling with vasoconstriction or due to excessive neointimal proliferation during scarring, which occurred in around 30-40% of patients.
Implantación de stents metálicos
Treatment with stents was further developed and strategies were designed to fix an arterial segment in any anatomic position. Stents were developed for bifurcations, for chronic and acute occlusions, for long lesions or small vessels, for the treatment of acute infarction or unstable angina, and for locations not previously approached, such as life-threatening left main coronary artery (LMCA) lesions. Imaging techniques were also developed for intracoronary flow that taught us previously unknown aspects, such as inappropriate apposition to the arterial wall. All this led to better supports and improved outcomes.