Chidambaram Rammohan is the Chief Cardiology Fellow at the Northwestern University Feinberg School of Medicine. He will begin an interventional cardiology fellowship in 2004. He trained in internal medicine at the San Francisco School of Medicine, University of California, where he was both the Junior and Senior Resident of the Year.

Abstract
Specific anatomic challenges and in-stent restenosis have been the impetus for new designs in stent technology. Drug-eluting stents, particularly the sirolimus-coated and paclitaxel-coated stents have shown efficacy in clinical trials. Ongoing studies involve the application of these stents in saphenous vein grafts, bifurcation lesions, and for in-stent restenosis. Other medications, especially everolimus, have also shown preliminary efficacy.

Stents covered with polytetrafluoroethylene are indicated for coronary perforations, and are being investigated for saphenous vein graft lesions. A randomised trial with a self-expanding polytetrafluoroethylene-covered stent in saphenous vein graft lesions is underway. Specialised stent designs for bifurcation lesions are also in development, and early safety data are promising for this challenging anatomic subset.

Recent advances in stent technology have improved clinical outcomes in percutaneous coronary intervention. Current technology aims to upgrade applications for percutaneous revascularisation, by reducing the incidence of restenosis and improving long-term prognosis in patients with complex coronary artery disease.