As the interventions available to treat obstructive coronary artery disease become increasingly complex, our understanding of the vascular response to these interventions requires greater sophistication. Molecular and cellular biologic tools have now propelled us into another phase of work with vascular devices. Initially, studies of endovascular implants such as stents focused on developing models of vascular injury. With these models, we could then examine the designs of individual stents and connect structure with performance. Now we are entering a third phase in which stent manufacturers are looking to science to dictate stent design.