No increased risk with drug eluting stents -- but late stent thrombosis remains a concern
Several large observational data sets have convincingly shown that there is no overall safety issue with drug eluting stents (DES) vs. bare metal stents (BMS). In fact, most registry studies suggest a lower risk of death or myocardial infarction with drug eluting stents. However, late occurring stent thrombosis still remains higher and seems to be uniquely associated with these stents. Late stent thrombosis is a rare but very serious event and all possible efforts should be made to avoid the complication by improving patient selection, optimizing the implantation technique and enhancing anti thrombotic treatment. With highly effective anti thrombotic treatments and novel drug eluting stent designs without potentially toxic polymers a clear reduction of death and myocardial infarction rates is highly probable.