Stent therapy plays a fundamental role in modern interventional cardiology, providing mechanical support to coronary arteries following angioplasty to restore blood flow and reduce ischemic burden. As stent technology evolves to include advanced drug coatings, thinner struts and more biocompatible polymers, clinicians frequently seek updated insights into Stent optimisation when attending an interventional track at a cardiology conference. Because correct device selection and deployment directly affect long-term outcomes such as restenosis, thrombosis and vessel healing, this session explores essential principles of procedural planning, imaging guidance and post-procedural management. The expanding landscape of coronary stent technology makes it essential for practitioners to stay current with clinical evidence and emerging innovations.

The session begins with the basics of stent mechanics, including radial strength, deliverability, recoil characteristics and conformability in tortuous anatomy. Participants learn how design differences between drug-eluting stents (DES), bare-metal stents and bioresorbable scaffolds influence restenosis rates, thrombotic risk and endothelial healing. Special attention is given to high-risk lesion subsets such as bifurcations, chronic total occlusions, calcified segments, ostial lesions and long diffuse disease where stent performance varies significantly.

Intravascular imaging forms a major component of this program. Delegates explore how IVUS and OCT enhance lesion assessment, guide optimal stent sizing and ensure full expansion and apposition. Imaging case examples demonstrate the consequences of underexpansion, edge dissection, malapposition and tissue protrusion—findings not always visible on angiography. Participants learn when imaging should be routine and how to incorporate it into workflow without adding unnecessary procedure time.

Procedural techniques such as lesion preparation, pre-dilation, post-dilation, pressure modulation and bifurcation strategies are addressed in depth. The session covers provisional stenting, two-stent bifurcation approaches, kissing balloon inflation, POT (proximal optimisation technique) and hybrid strategies that combine different tools for optimal results. Real-world challenges such as stent delivery failure, calcified underexpansion, wire bias and hemodynamic instability are analysed through step-by-step algorithms.

Post-procedural considerations include DAPT selection, duration of therapy, managing bleeding risk and balancing ischemic protection. The session highlights risk-adapted antiplatelet approaches, especially in elderly patients, those with prior bleeding or individuals undergoing complex PCI. Participants also review surveillance strategies, managing recurrent symptoms and identifying restenosis or late thrombosis during follow-up.

Future directions include ultra-thin strut DES, polymer-free drug platforms, sirolimus-coated scaffolds, bioresorbable magnesium stents and dedicated bifurcation devices. AI-enhanced imaging interpretation and robotics-assisted stent deployment are also discussed. By the end of this session, clinicians will understand principles of optimal stent selection, safe implantation and evidence-based aftercare to achieve durable results in a broad spectrum of coronary interventions.