3. Intracoronary Stents: Medical Devices at the Interface of Biology and Electrochemistry

Despite the many significant advances in the diagnosis and treatment of cardiovascular diseases that have occurred over the past three decades, these disorders remain a primary cause of both morbidity and mortality worldwide. In fact, ischaemic heart disease (essentially, heart attacks and their sequelae) are the single leading cause of death, accounting for almost 13 % of deaths worldwide [1]. Since their introduction nearly 20 years ago, intracoronary stents have become an indispensable tool in the arsenal of interventional cardiologists for the prevention and treatment of ischaemic heart disease. These devices, generally consisting of a tubular metal scaffold with some coating to ensure biocompatibility and reduce complications (Fig. 3.1), serve to restore patency to occluded arteries and to stave off their reocclusion. What is fascinating about stents is that they stand at the interface of the fields of engineering, chemistry (particularly materials chemistry and electrochemistry), biology, and medicine. In this chapter, we will review some of the disease biology of atherosclerosis—the pathological process that ultimately gives rise to ischaemic heart disease—before reviewing the history of stent development and some of the common features of these devices. The heart of this chapter, however, will focus on the ongoing research in the area of electrochemistry that is aimed at optimizing the properties of intracoronary stents.