Drug-eluting stents (DES) would not be used if they did not benefit patients. To that end, vendors conduct clinical studies to show that their product is equal to or better than a previous-generation product or a current competitor’s product.

In our cover story, the four major DES vendors discuss in a lively forum how their particular products have fared in clinical studies, pointing out results that they hope will act as differentiators to sway cardiologists and service line administrators to buy one stent over another.

We are in transition regarding the maturity of DES. First, there were positive results, then negative and now positive again. There are several reasons for this seesaw effect including riding a learning curve, developing better patient selection and improving the stents. You will read in our cover story how second-generation DES are proving better than the first in several categories.

There are more to stents, however, than the actual device. Other factors to consider, for example, include deciding on the best dual-antiplatelet therapy and who is best qualified to perform PCI. Regarding the latter, you will read in this issue how the phenomenon of performing PCIs in facilities without surgical backup is becoming more prevalent and—dare I say—more accepted. While there are advantages to performing PCI without surgical backup, such as having the treatment available in rural areas, there are also disadvantages. Those include potentially glutting an urban market and glomming business from Centers of Excellence.

Finally, I’d like to draw your attention to a new feature and relationship for Cardiovascular Business: The ACC Corner. This recurring column will be authored by luminary members of the American College of Cardiology and will highlight pressing concerns within cardiology and efforts underway by the ACC and others to address them.

If you have any comments regarding this issue of Cardiovascular Business, please send them my way.