Diabetic revascularisation by coronary angioplasty: is one stent better than another?

As confidence in the use of drug-eluting stents (DES) increases, they are being used in patients with progressively more complex disease. Diabetes is still an independent risk factor for restenosis along with lesion length and reference vessel diameter.
This article gives an overview of recent stenting trials, including those with more complex disease such as DIABETES, PORTO 1 and TAXUS V. It also looks at head-to-head randomised controlled trials of sirolimus-eluting stents against paclitaxel-eluting stents: ISAR-DESIRE, SIRTAX, ISAR-DIABETES and REALITY. These give a better indicator of comparative efficacy than meta-analyses which include differing patient populations and trial designs. Finally, studies comparing angioplasty with surgery are considered.