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(Circulation. 1996;94:882-890.)
© 1996 American Heart Association, Inc.

Articles

Intracoronary Stenting

From Concept to Custom

Peter N. Ruygrok, MB, ChB, FRACP; Patrick W. Serruys, MD, PhD

the Catheterization Laboratory, Thoraxcenter, Erasmus University, Rotterdam.

Correspondence to Patrick W. Serruys, MD, Catheterization Laboratory, Thoraxcenter BD 432, University Hospital Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands.

Key Words: stents • angioplasty • atherosclerosis • coronary disease

	Introduction

 
When Charles Stent, a 19th century English dentist, developed a mold with which to form an impression of the teeth and oral cavity, he would never have imagined that his name would become synonymous with the management of obstructive vascular disease, in particular coronary artery disease (Fig 1).¹ The term "stent" became associated with a device that held a skin graft in position, a support for tubular structures that were being anastomosed, and, more recently, an endovascular scaffolding to relieve and prevent vascular obstructions.

View larger version (56K): [in this window] [in a new window]   Figure 1. Charles Stent (1845-1901), an English dentist who lent his name to a tooth mold (bottom) and more recently to endoluminal scaffolding devices.

The management of coronary atherosclerosis has shifted from "masterly inactivity" to medical therapy, coronary bypass surgery, and, more recently, percutaneous techniques introduced by Gruentzig et al in 1977.² Intracoronary stenting with continuing refinements appears poised to become the mainstay of the mechanical treatment of obstructive coronary disease.

	Preclinical Evaluation

 
In his 1912 Nobel lecture, laureate Alexis Carrel described experiments with glass and metal tubes covered with paraffin that were introduced into canine thoracic aortae. Coagulation did not occur provided the aortic wall was not ulcerated, with one animal surviving for 90 days with a glass tube. He concluded that the presence of foreign bodies within vessels did not necessarily produce thrombus.

The concept of using an implantable prosthetic device to maintain the luminal integrity of diseased vessels was reintroduced by Charles Dotter in 1964, when he suggested that the temporary use of a . . . [Full Text of this Article]

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