The Resolute™ Integrity Zotarolimus-Eluting Stent in Coronary Artery Disease: A Review

The introduction of first-generation drug-eluting stents (DES) was a major advance in the percutaneous treatment of coronary artery disease, with DES significantly reducing the incidence of restenosis and major adverse coronary events compared with bare metal stents. Next-generation DES now utilizes lower profiles, thinner struts, and other technological advances to help extend their safety and efficacy. Importantly, studies of next-generation devices have now gone beyond controlled clinical trials with selected populations to registries and studies with all-comer populations, where more diverse and complex sets of patients and lesions have been managed. Thus, a large body of evidence and comparative data about the safety and efficacy of these devices has accumulated. The Resolute™ zotarolimus-eluting stent (R-ZES; Medtronic Inc., Santa Rosa, CA, USA) is a next-generation DES that uses a novel biocompatible polymer on a cobalt alloy stent platform to extend the duration of drug elution and improve the stent's efficacy. The Integrity™ platform (Medtronic, Inc., Santa Rosa, CA, USA) used in the most recent iteration of the R-ZES stent further enhances the flexibility and deliverability of the stent in complex lesions by incorporation of a continuous sinusoidal design. In the following review, the clinical data is critically examined for the R-ZES and discuss its performance using comparative data currently available for next-generation DES. It is concluded that R-ZES use in complex patients and lesions is associated with durable efficacy and safety and represents another generational improvement in DES technology, which undoubtedly will enhance patient outcomes postpercutaneous coronary interventional.