Cardiovascular stents: overview, evolution, and next generation.
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TLDR
This study mostly sheds light on DES’s concepts, namely stent composition, drug release mechanism, and coating techniques, and reports different forms of DES including fully biodegradable DESs, shape-memory ones, and polymer-free DESs.Abstract:
Compared to bare-metal stents (BMSs), drug-eluting stents (DESs) have been regarded as a revolutionary change in coronary artery diseases (CADs). Releasing pharmaceutical agents from the stent surface was a promising progress in the realm of cardiovascular stents. Despite supreme advantages over BMSs, in-stent restenosis (ISR) and long-term safety of DESs are still deemed ongoing concerns over clinically application of DESs. The failure of DESs for long-term clinical use is associated with following factors including permanent polymeric coating materials, metallic stent platforms, non-optimal drug releasing condition, and factors that have recently been supposed as contributory factors such as degradation products of polymers, metal ions due to erosion and degradation of metals and their alloys utilizing in some stents as metal frameworks. Discovering the direct relation between stent materials and associating adverse effects is a complicated process, and yet it has not been resolved. For clinical success it is of significant importance to optimize DES design and explore novel strategies to overcome all problems including inflammatory response, delay endothelialization, and sub-acute stent thrombosis (ST) simultaneously. In this work, scientific reports are reviewed particularly focusing on recent advancements in DES design which covers both potential improvements of existing and recently novel prototype stent fabrications. Covering a wide range of information from the BMSs to recent advancement, this study mostly sheds light on DES’s concepts, namely stent composition, drug release mechanism, and coating techniques. This review further reports different forms of DES including fully biodegradable DESs, shape-memory ones, and polymer-free DESs.read more
Citations
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References
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A Comparison of Balloon-Expandable-Stent Implantation with Balloon Angioplasty in Patients with Coronary Artery Disease
Patrick W. Serruys,P. de Jaegere,Ferdinand Kiemeneij,Carlos Macaya,Wolfgang Rutsch,Gr. Heyndrickx,H. Emanuelsson,Jean Marco,Victor Legrand,P. Materne +9 more
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A Randomized Comparison of Coronary-Stent Placement and Balloon Angioplasty in the Treatment of Coronary Artery Disease
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TL;DR: In selected patients, placement of an intracoronary stent, as compared with balloon angioplasty, results in an improved rate of procedural success, a lower rate of angiographically detected restenosis, a similar rate of clinical events after six months, and a less frequent need for revascularization of the original coronary lesion.
Journal ArticleDOI
Pathology of Drug-Eluting Stents in Humans: Delayed Healing and Late Thrombotic Risk
Michael Joner,Aloke V. Finn,Andrew Farb,Erik Mont,Frank D. Kolodgie,Elena Ladich,Robert Kutys,Kristi Skorija,Herman K. Gold,Renu Virmani +9 more
TL;DR: The Cypher and Taxus DES result in delayed arterial healing when compared with BMS of similar implant duration, and the cause of DES LST is multifactorial with delayed healing in combination with other clinical and procedural risk factors playing a role.
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Viscosity, Plasticity, and Diffusion as Examples of Absolute Reaction Rates
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The manufacturing techniques of various drug loaded biodegradable poly(lactide-co-glycolide) (PLGA) devices.
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