evolution of coronary stents

Jiang W., Zhao W., Zhou T., Wang L., Qiu T. A review on manufacturing and post-processing technology of vascular stents. Bioresorbable metals in cardiovascular stents: material insights and progress. Very late ST, although now recognized as a possible complication of first-generation DES, is a rare entity and numerous meta-analyses and data registries have provided reassurance about the use of such devices.12, Major Randomized Controlled Trials Comparing Bare Metal Stents With Current-generation Drug-eluting Stents. These data were confirmed by meta-analyses and clinical registries27 and mainly referred to the Absorb BVS, which is so far the most widely used scaffold and the only one with CE mark and FDA approval. Among the critical areas for stress are areas close to the fork, the contact point of the stent slits, the end of the plate, the curved parts of the stent, as well as the corners, and the middle of the slit. The radial force of a BVS is weaker than the force of DES, so recoil can be a problem because of the rapid absorption. Pharmaceutical stents or drug-coated metal stents are some of the most popular types of stents today. Stone G.W., Moses J.W., Ellis S.G., Schofer J., Dawkins K.D., Morice M.C., Colombo A., Schampaert E., Grube E., Kirtane A.J., Cutlip D.E., Fahy M., Pocock S.J., Mehran R., Leon M.B. 121-129. Doostzadeh J, Clark LN, Bezenek S, Pierson W, Sood PR, Sudhir K. Coron Artery Dis. The Evolution of Coronary Stents: A Brief Review Challenges With Current Stents. Stent Ho M.Y., Chen C.C., Wang C.Y., Chang S.H., Hsieh M.J., Lee C.H., Wu V.C.C., Hsieh I.C. Stent Evolution of the coronary artery stent - PubMed Charpentier E., Barna A., Guillevin L., Juliard J.-M. Biolimus-eluting stent with biodegradable polymer versus sirolimus-eluting stent with durable polymer for coronary revascularisation (LEADERS): a randomised non-inferiority trial. HHS Vulnerability Disclosure, Help This phenomenon is called Foreshortening, which is measured by Eq. Conflict of interest: R.M. Implantation of the most appropriate stent is important to the patient to reduce the risk of complications. Bnaa, J. Mannsverk, R. Wiseth, NORSTENT Investigators. Epub 2014 Nov 4. Expanded Polytetrafluoroethylene Membranes for Vascular Stent Coating: Manufacturing, Biomedical and Surgical Applications, Innovations and Case Reports. Superficial features of coronary stents play an important role in inhibiting stent restenosis and also late stent thrombosis [16]. Indeed, there is still a long road ahead before BRS can be routinely used in clinical practice. Micro-CT images of stents and the strut design [95]. Iqbal J., Gunn J., Serruys P.W. Dotter C.T., Judkins M.P. In balloon-expandable stents, the stent is placed with the delivery system in the desired location and then deployed by the expansion of an expanded balloon (Fig. Percutaneous coronary intervention (PCI) remains the cornerstone in the management of patients with acute coronary syndrome and those with chronic coronary syndrome refractory to medical management. eCollection 2021 Dec. Mayo Clin Proc Innov Qual Outcomes. This work discusses POBA, why there was a need for BMS, the use of inhibiting drugs to create 1st generation DES, the change of components to 2nd generation DES, the use of absorbable drug reservoirs and platforms, and possible future directions with Prohealing Endothelial Progenitor Cell Capture Stents. Gruntzig A.R., Senning A., Siegenthaler W.E. Connectors: attach the adjacent rings and can be straight or curved or can be direct welds that link the rings directly. There are several procedures for occluding arteries, including bypass, angioplasty by balloon, and stenting. 3(c) demonstrates the electrospinning technology [92], and Fig. Areas covered: The conversion from plain old balloon angioplasty (POBA) to the present era of drug eluting stents (DES) has been driven by many technological advances and large bodies of clinical trial evidence. Important parameters in the design of stents. Condello F, Spaccarotella C, Sorrentino S, Indolfi C, Stefanini GG, Polimeni A. J Clin Med. Biodegradable coronary scaffolds: their future and clinical and technological challenges. Front Med Technol. Tidwell K, Harriet S, Barot V, Bauer A, Vaughan MB, Hossan MR. Bioengineering (Basel). Kolandaivelu K., Swaminathan R., Gibson W.J., Kolachalama V.B., Ehrenreich K.L.N., Giddings V.L., Coleman L., Wong G.K., Edelman E.R. Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized controlled trial. 2009 Dec 15;5 Suppl F:F36-42. 2014 Jan;7(1):55-63. doi: 10.1016/j.jcin.2013.07.012. Everolimus-Eluting Stents in Patients With Bare-Metal and Drug-Eluting In-Stent Restenosis: Results From a Patient-Level Pooled Analysis of the RIBS IV and V Trials. The ideal stent should meet a broad span of technical versions. These deposits form a large number of plaques that lead to thickening of the arterial wall, blockage of blood vessels, and affect blood flow. TCTMD is produced by the Cardiovascular Research Foundation (CRF). 8600 Rockville Pike Would you like email updates of new search results? Guildford A., Santin M., Phillips G.J. Stents with symmetrical link configurations have high flexibility [96]. Imai M., Inoue K., Kimura T. Comparative pathological findings between coronary bare-metal stent implantation and balloon angioplasty over 16 years. HHS Vulnerability Disclosure, Help The site is secure. Outcomes of Percutaneous Coronary Intervention for InStent Numerous published studies center on the clinical, technological, and material features of bioabsorbable stents [33,53,[69], [70], [71], [72]]. 3D printing of smart materials: a review on recent progresses in 4D printing. 2 showed the stent designed by Dotter et al. Novel Approaches for Preventing or Limiting Events in diabetic patients (Naples- Diabetes) trial: a randomized comparison of 3 drug-eluting stents in diabetic patients. Outcomes associated with drug-eluting and bare-metal stents: a collaborative network meta-analysis. Coronary Stents Serruys P.W., Jaegere P., Kiemeneij F., Macaya C., Rutsch W., Heyndrickx G., Emanuelsson H., Marco J., Legrand V., Materne P., Belardi J., Sigwart U., Colombo A., Goy J.J., Heuvel P., Delcan J., Morel M. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. 2022 Sep 21;7(10):985-997. doi: 10.1016/j.jacbts.2022.05.002. Outcome differences with the use of drug-eluting stents for the treatment of in-stent restenosis of bare-metal stents versus drug-eluting stents. eCollection 2023. Compared with balloon angioplasty, bare-metal stents effectively prevented abrupt vessel Cardiovasc Interv Ther. and transmitted securely. Mishra S. Structural and design evolution of bio-resorbable scaffolds: the journey so far. Abrupt occlusion obliged the pioneers of coronary angioplasty to have an active surgical stand-by during these procedures. C. Von Birgelen, M.W. PMC J Am Coll Cardiol., 65 (2015), pp. Long-Term Safety of Drug-Eluting and Bare-Metal Stents Evidence From a Comprehensive Network Meta-Analysis. 2023 Mar 1;15(3):e35651. The Author(s) 2022. Study on the impact of straight stents on arteries with different curvatures. With these coronary stents, doctors were able to keep the artery patent or open for longer periods. In past studies, intracoronary stent restenosis was reported to be between 10% and 20% during a six-month follow-up, leading to myocardial infarction and angina, which required re-vascularization [52]. Increased stent opening pressure is one of the factors that reduce the retraction and the ratio of a metal surface to low vessels, as well as the greater thickness of the stent, are the factors that increase this complication. Medical Device Materials II - Proceedings of the Materials and Processes for Medical Devices Conference 2004. Researchers are working on ways to improve current stent angioplasty procedures or add adjunctive therapies. Bioresorbable scaffolds could be either a metallic alloy (magnesium or iron alloy) or an L-isomer of PLLA polymeric platform, covered with a polymer and an antiproliferative drug. The development of coronary artery stents: from bare-metal to bio-resorbable types. The researchers successfully solved the difficulty of vascular occlusion with bare-metal stents and later developed a drug-eluting stent to minimize restenosis. Tomberli B., Mattesini A., Baldereschi G.I., Mario C.D. [68]. Prediction of strength and radial recoil of various stents using FE analysis. Closed-cell stents are less flexible and may have incomplete complexity and expansion. eCollection 2022 Oct. Simard T, Jung RG, Di Santo P, Harnett DT, Abdel-Razek O, Ramirez FD, Motazedian P, Parlow S, Labinaz A, Moreland R, Marbach J, Poulin A, Levi A, Majeed K, Boland P, Couture E, Sarathy K, Promislow S, Russo JJ, Chong AY, So D, Froeschl M, Dick A, Labinaz M, Le May M, Holmes DR Jr, Hibbert B. Mayo Clin Proc Innov Qual Outcomes. An official website of the United States government. Mussel-inspired elastic interpenetrated network hydrogel as an alternative for anti-thrombotic stent coating membrane. Medicine (Baltimore). All rights reserved. In-stent restenosis and stent thrombosis may also be determined by patient risk factors (ie, diabetes, smoking), anatomical features of the treated vessel (such as heavy calcified lesions, diameter of the vessel, the presence of side branches) or inadequate stenting (strut thickness, stent malapposition, inadequate stent diameter). Please enable it to take advantage of the complete set of features! Such substances are called bioabsorbable [66]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2013 Dec 10. More than a decade later, in 1977, Gruentzig performed the first balloon percutaneous transluminal coronary angioplasty (or POBA, plain old balloon angioplasty, as it was later called) in a conscious man, starting a revolution in the treatment of CAD. Effectiveness of drug-coated balloon in acute myocardial infarction: A protocol for systematic review and meta-analysis. Martin D.M., Boyle F.J. Drug-eluting stents for coronary artery disease: a review. 3(ad)) [[89], [90], [91], [92], [93]]. A, B, C: Struts, rings, cells, crowns and connectors form the backbone of a stent. The idea of the bioresorbable stent is considered revolutionary according to Erne et al. Am J Cardiol. These infections can lead to coronary perforations and mycotic aneurysms. Stent thrombosis late after implantation of first-generation drug-eluting stents: a cause for concern. Twenty-Year Evolution of Percutaneous Coronary Intervention and An official website of the United States government. The other authors have nothing to disclose. Several parameters are significant in the design of stents, which are introduced in Table 3 [[95], [96], [97], [98], [99], [100], [101], [102], [103]] and explained in detail in the following. Cardiology Today | Throughout the history of cardiology, several milestones have marked modern medicines fascination with and research into the heart: the first After a period of balloon angioplasty, which was marred by risk of abrupt vessel closure and vessel recoil, balloon expandable metal alloy stents were the mainstay of PCI. Cassar A., Jr D.R.H., Rihal C.S., Gersh B.J., Gps N., Qbujfou F. Chronic coronary artery disease: diagnosis and management. Stenting is one of the most important strategies to remedy atherosclerosis. Stents are small cylindrical scaffolds whose main purpose is to remove the arterial obstruction or to prevent elastic arterial reversibility following dilation of the artery or balloon angioplasty [10,11]. Circ Cardiovasc Interv. Comparison of vascular stents with different links. official website and that any information you provide is encrypted Recent advances in the production of additives and the development of materials have led to four-dimensional (4D) printing technology to create dynamic devices that can change their shape and function on demand and over time. Angioplasty with a stent is a procedure to open narrowed or blocked blood vessels. In: StatPearls [Internet]. Krankenberg H., Zeller T., Ingwersen M., Schmalstieg J., Gissler H.M., Nikol S., Baumgartner I., Diehm N., Nickling E., Hulsbeck S.M., Schmiedel R., Torsello G., Hochholzer W., Stelzner C., Brechtel K., Ito W., Kickuth R., Blessing E., Thieme M., Nakonieczny J., Nolte T., Gareis R., Boden H., Sixt S. Self-expanding versus balloon-expandable stents for Iliac artery occlusive disease. Therefore, a new strategy to eliminate polymer-mediated complications has been the development of polymer-free DES, which can theoretically avoid these long-term negative effects, decreasing the rate of ST and allowing a shorter duration of DAPT. 4004237. FOIA O'Brien B., Carroll W. The evolution of cardiovascular stent materials and surfaces in response to clinical drivers: a review. Block P.C. Innovations in angioplasty and stents continue for challenging treatments. Therefore, the best stent required should be used according to the required features [94]. 7). Today, coronary stents have become the most usual treatment for coronary artery disease. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. National Library of Medicine The first stents were made from stainless steel and, despite their thick struts and poor flexibility, showed superiority over POBA, with elimination of abrupt occlusion and a reduced rate of restenosis, confirmed in 2 historic trials published in 1993 (the BENESTENT and the STRESS trials1,2). EuroIntervention., 12 (2016), pp. Doostzadeh J, Clark LN, Bezenek S, Pierson W, Sood PR, Sudhir K. Coron Artery Dis. The rationale behind their use is to create a temporary mechanical support in the vessel in order to prevent immediate restenosis and vascular recoil, then allowing it to degrade over time, eliminating the long-term risk associated with the presence of a metallic scaffold. Steinberg DH, Gaglia MA Jr, Pinto Slottow TL, Roy P, Bonello L, De Labriolle A, Lemesle G, Torguson R, Kineshige K, Xue Z, Suddath WO, Kent KM, Satler LF, Pichard AD, Lindsay J, Waksman R. Am J Cardiol. Park H., Ahn J.M., Kang D.Y., Kim S.O., Ko E., Kim T.O., Lee P.H., Lee S.W., Park S.W., Park D.W., Park S.J. Therefore, in some cases, balloon-expandable stents are not suitable and require self-expanding stents [104,114]. The .gov means its official. coronary This site needs JavaScript to work properly. Stent Selection of coronary stents. 3(b) depicts laser cutting stents [91], Fig. Naito R, Miyauchi K, Konishi H, Tsuboi S, Ogita M, Dohi T, Kasai T, Tamura H, Okazaki S, Isoda K, Daida H. Intern Med. Eshghi N., Hojjati M.H., Imani M., Goudarzi A.M. Finite element analysis of mechanical behaviors of coronary stent. Wang M.Y., Wang F., Liu Y.S., Yu L.J. The https:// ensures that you are connecting to the The https:// ensures that you are connecting to the

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