Perspective:

Drug-eluting stents have represented a major breakthrough by markedly reducing restenosis rates following coronary stenting. Although local release of mTORC1 inhibitors has been highly successful in reducing exuberant proliferative responses to vascular injury, they also impair stent coverage by endothelial cells, extending the risk for stent thrombosis and necessitating prolonged dual antiplatelet therapy (DAPT). The Combo stent was thus designed with an anti-CD34 antibody coating to capture circulating endothelial progenitor cells with hopes of promoting re-endothelialization. Previous preclinical porcine studies enabling both OCT and histological assessment of stents at various time points following deployment demonstrated that the Combo platform promoted endothelialization while reducing neointimal formation and inflammation. Whether this promising technology will lead to superior clinical outcomes, and possibly reduced need for prolonged DAPT, will require further study, including high-risk patients.