• Newer-generation drug-eluting stents (DES) with biodegradable polymer or polymer-free platforms significantly reduce very late stent thrombosis compared to older DES.
• Personalized antiplatelet therapy and intracoronary imaging guidance improve clinical outcomes in patients receiving DES.
• Stent fracture and neoatherosclerosis remain significant long-term complications, necessitating careful patient selection and follow-up.
• Emerging technologies such as bioresorbable scaffolds and drug-coated balloons offer promising alternatives, but require further long-term data.