New Stents for Acute Coronary Syndrome

Acute coronary syndrome (ACS) is characterized by a rupture of an atherosclerotic plaque which initiates thrombus formation at the site of plaque rupture. Persistent and complete thrombotic occlusion of a coronary artery results in ST-segment elevation myocardial infarction (STEMI), while incomplete occlusion may cause ACS non-ST-segment elevation myocardial infarction (NSTEMI). One of the important features in ACS is the thrombus; large thrombus burden is related to distal embolization which causes microvascular obstruction despite adequate epicardial perfusion. Coronary reperfusion after STEMI improves outcome; reperfusion can be achieved by thrombolytic therapy or PCI. Most data regarding drug-eluting stents (DES) in ACS suggest that the use of DESs is safe, but they do not prevent thrombus embolization or no reflow phenomenon. New stents such as the mesh-covered MGuard may prevent embolization, and show short-term promising results; however, late follow-up data for these stents are still required.