Abstract
Angioplasty of the coronary arteries has made significant headway in the past 20 years as a treatment for atherosclerotic vascular disease. Though drug-eluting stents are effective, they appear to invoke a thrombogenic response. Biodegradable stents are a promising alternative to permanent stents and may eventually be used to solve the lingering problem of in-stent restenosis. Additionally, fully degradable stents have the ability to deliver more drugs to the target site than a thin coating of drug on metallic stents. A variety of degradable materials have been studied for stent design, including polyesters, polycarbonates, bacterial-derived polymers, and corrodible metals. The ideal biodegradable stent would be reliably deployable under fluoroscopic guidance and situate into the target lesion with minimal endovascular trauma. The stent should degrade into nontoxic byproducts and invoke a minimal degree of inflammation at the target site. Finally, the stent itself should disappear within months (to years) without significant displacement from the deployment site. Although initial data from clinical trials have been sufficient to bring biodegradable materials into the realm of feasibility, future research is undoubtedly necessary to resolve the critical issues of inflammation and mechanical stability.
Keywords: Restenosis, stent, drug, bioabsorption, biodegradation, Angioplasty, atherosclerotic vascular disease, polyesters, polycarbonate, femoral artery., Intravascular ultrasound, in-stent restenosis, brachytherapy, sirolimus, tacrolimus, everolimus, zotarolimus, mycophenolic acid, thrombosis, antiplatelet therapy, poly-L-lactic acid, polyglycolic acid, poly-anhydrides, minimal lumen diameter, ST638, tyrosine kinase inhibitor, neointimal hyperplasia, optical coherence tomography, endothelialization, salicylic acid, poly-anhydride ester, salicylic-acid polymer, magnetic resonance imaging, anti-ferromagnetism
Current Pharmaceutical Design
Title: Biodegradable and Bioabsorbable Stents
Volume: 16 Issue: 36
Author(s): Ron Waksman and Rajbabu Pakala
Affiliation:
Keywords: Restenosis, stent, drug, bioabsorption, biodegradation, Angioplasty, atherosclerotic vascular disease, polyesters, polycarbonate, femoral artery., Intravascular ultrasound, in-stent restenosis, brachytherapy, sirolimus, tacrolimus, everolimus, zotarolimus, mycophenolic acid, thrombosis, antiplatelet therapy, poly-L-lactic acid, polyglycolic acid, poly-anhydrides, minimal lumen diameter, ST638, tyrosine kinase inhibitor, neointimal hyperplasia, optical coherence tomography, endothelialization, salicylic acid, poly-anhydride ester, salicylic-acid polymer, magnetic resonance imaging, anti-ferromagnetism
Abstract: Angioplasty of the coronary arteries has made significant headway in the past 20 years as a treatment for atherosclerotic vascular disease. Though drug-eluting stents are effective, they appear to invoke a thrombogenic response. Biodegradable stents are a promising alternative to permanent stents and may eventually be used to solve the lingering problem of in-stent restenosis. Additionally, fully degradable stents have the ability to deliver more drugs to the target site than a thin coating of drug on metallic stents. A variety of degradable materials have been studied for stent design, including polyesters, polycarbonates, bacterial-derived polymers, and corrodible metals. The ideal biodegradable stent would be reliably deployable under fluoroscopic guidance and situate into the target lesion with minimal endovascular trauma. The stent should degrade into nontoxic byproducts and invoke a minimal degree of inflammation at the target site. Finally, the stent itself should disappear within months (to years) without significant displacement from the deployment site. Although initial data from clinical trials have been sufficient to bring biodegradable materials into the realm of feasibility, future research is undoubtedly necessary to resolve the critical issues of inflammation and mechanical stability.
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Cite this article as:
Waksman Ron and Pakala Rajbabu, Biodegradable and Bioabsorbable Stents, Current Pharmaceutical Design 2010; 16 (36) . https://dx.doi.org/10.2174/138161210794454905
DOI https://dx.doi.org/10.2174/138161210794454905 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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