NEJM 8 Mar 2007 Vol 356

It all began more than a hundred years ago, when a London dentist, Charles Stent, devised a little metal structure to hold in place gingival grafts. His name bears a fortuitous resemblance to the Indo-European root for stand and stay (etc) so it does nicely for the purpose.

Tubular stents have been tried in all sorts of blocked internal tubes, for the last decade above all in the coronary arteries. Bare metal ones are prone to block early, especially in patients who show immune activation against the metal, and to counteract this stents have been armed with different kinds of immune suppressant, including local radioactivity, which caused coronary artery fibrosis. After a profusion of trials with exotic acronyms, the Stent Wars narrowed down to single combat between stents coated with two agents, sirolimus and paclitaxel, which leach out (“elute