Beyond their originally sole mechanical function, current drug-eluting stents (DES) implement the concept of
local drug delivery for the re-opening of stenotic arterial vessels, and for prevention of in-stent restenosis as one of the
major limitations of conventional bare metal stents (BMS). Current DES consist of a permanent metallic stent platform
and an active agent being released from a drug-incorporated polymer coating or a porous stent surface. Although DES
have impressively demonstrated their capability of reducing in-stent restenosis, their safety remains under debate due to
potential risks, such as delayed healing, late thrombosis and hypersensitivity demanding further development. Current advancements
in the stent design address the stent platform, the pharmacologically active substance and/or the drug carrier.
For instance, novel biocompatible absorbable stent platforms and drug carriers are developed and novel drugs with a differential
effect on vascular endothelial and smooth muscle cells, providing efficient inhibition of muscle cells without altering
the endothelial cell function, are identified. Moreover, biofunctionalization of the stent’s surface with capture molecules
for endothelial progenitor cells are under investigation in order to achieve an in situ endothelialization of the implant.
In this context, this review paper discusses the current advances in coronary stent technology with a special focus on novel
stent platforms, drugs and stent coatings for the prevention of restenosis and improvement of biocompatibility.