Currently used stents face similar pathophysiologic changes leading to failure as do small calibre vascular prostheses. The main drawbacks are early thrambagenicity and late intimal hyperplasia. Many solutions including passive and active coatings have been propased. The promising application of drug-elution, mainly anti-thrombatic or anti-prolijerative, has shown clinical improvements in PCI treatment ofmyocardial ischaemia. Despite better longterm results, coronary bypass surgery is only performed with autologous arteries and veins due ta poor results with small calibre synthetic vascular grafts. Newer approaches such as drug-elution in biodegradable stents or vascular prostheses may further improve the longterm clinical results due to a better dosage and continuous drug-release. However, safety and efficacy issues comprise in vivo drug dosage/release/activity after manufacturing/sterilization and storage, as well as mechanical integrity, degradation products of biodegradable stents and vascular prostheses. Finally, financial and regulatory issues may limit wide application of high end biotechnological cardiovascular products.