Since its introduction in 1977, percutaneous coronary intervention has 
become one of the most commonly performed therapeutic procedures 
worldwide. Such widespread diffusion, however, would have not been 
possible without a concomitant evolution of the pharmacotherapies 
associated with this intervention. Antithrombotic agents are fundamental
 throughout the management of patients undergoing coronary stent 
implantation, starting from the procedure itself to the long-term 
prevention of cardiovascular events. The last 40 years of interventional
 cardiology have seen remarkable improvements in both drug therapies and
 device technologies, which largely reflected a progressive 
understanding of the pathophysiological mechanisms of coronary artery 
disease, as well as procedure- and device-related adverse events. The 
purpose of this article is to provide an overview of the important 
milestones in antithrombotic pharmacology that have shaped clinical 
practice of today while also providing insights into knowledge gaps and 
future directions.