Biodegradable polymer stents<i>vs</i>second generation drug eluting stents: A meta-analysis and systematic review of randomized controlled trials

Pandya, Bhavi; Gaddam, Sainath; Raza, Muhammad; Asti, Deepak; Nalluri, Nikhil; Vazzana, Thomas; Kandov, Ruben; Lafferty, James

doi:10.4330/wjc.v8.i2.240

Cited by 16 publications

(16 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with observed positive remodeling in relation to a coronary stent should be considered at high risk of further ST and long term dual anti-platelet therapy should be considered. Polymer-free drug eluting stents or bio-absorbable stent scaffold, may theoretically offer a solution, however more long term efficacy data is needed given similar rates of ST after 16 months (6). These cases also illustrate the utility of IVUS, in defining pathology as well as directing definitive treatment.…”

Section: Discussionmentioning

confidence: 94%

Right coronary artery thrombosis within drug eluting stents more than 10 years after deployment: Two cases of very, very late stent thrombosis

Lovibond¹,

Leung²

2017

HVT

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 94%

Right coronary artery thrombosis within drug eluting stents more than 10 years after deployment: Two cases of very, very late stent thrombosis

Lovibond¹,

Leung²

2017

HVT

View full text Add to dashboard Cite

show abstract

“…New generation DES (BP‐DES or DP‐DES) have been extensively evaluated in published studies and demonstrated to be associated with improved efficacy and safety profiles compared to first‐generation DES . Recent evidence derived from systematic review and meta‐analyses of randomized controlled trials showed that BP‐DES have similar efficacy and safety profiles compared with DP‐DES . However, there is a paucity of clinical data on comparative outcomes between BP‐DES and DP‐DES in real‐world patients undergoing PCI.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have established the superiority of BP‐DES and DP‐DES over first‐generation DES in reducing risk of late ST and repeat target vessel revascularization . Recent evidence derived from systematic review and meta‐analyses of randomized controlled trials showed that BP‐DES have similar efficacy and safety profiles compared with DP‐DES in terms of ST, target vessel revascularization, MI, and death . However, there is a paucity of data comparing BP‐DES and DP‐DES in a real‐world setting where patients in clinical practice often have more complex lesions and other comorbidities .…”

Section: Introductionmentioning

confidence: 99%

A propensity score‐matched comparison of biodegradable polymer vs second‐generation durable polymer drug‐eluting stents in a real‐world population

Zhao¹,

Teng²,

Khoo³

et al. 2018

Cardiovascular Therapeutics

View full text Add to dashboard Cite

show abstract

“…Partially bioresorbable polymer DESs have also been shown to have non-inferior results compared to second generation DESs at one year; in one meta-analysis including 11 randomized clinical trials the biodegradable polymer stents didn't show advantageous outcomes of stent thrombosis, target lesion revascularization, myocardial infarction, and cardiac death than permanent polymer stents [67]. However, further studies are needed regarding the long-term outcomes.…”

Section: Partially-bioresorbable Stentsmentioning

confidence: 99%

The Development of Coronary Artery Stents: From Bare-Metal to Bio-Resorbable Types

Chen

Wang

et al. 2016

Metals

View full text Add to dashboard Cite

Abstract:Coronary artery disease is the leading cause of death worldwide. Conventional balloon angioplasty is associated with high rates of complications such as coronary dissection and vessel recoil. The deployment of bare-metal stents (BMSs) can overcome these problems and achieve a better patency rate than simple balloon angioplasty. It has been shown that the stent design including structure platform, size, length, and strut thickness has a major influence on the clinical results. Even though angioplasty with BMS implantation is widely used in coronary interventions, the restenosis rate due to neointimal hyperplasia remains high. Therefore, drug-eluting stents (DESs) coated with anti-proliferative agents and polymers have been developed to reduce the restenosis rate and improve the clinical outcomes. Although the repeat revascularization rate of DESs is lower than that of BMSs, the long-term stent thrombosis rate is higher than for BMSs. Therefore, new and emerging generations of stents, in which, for example, thinner struts and bioresorbable polymers are used, are available for clinical use. However, there are only a limited number of clinical trials, in which these newer stents have been compared with BMSs and first-and second-generation DESs. The purpose of this review was to provide up-to-date information on the evolution of coronary artery stents from BMSs to DESs to bioresorbable stents (BRSs).Keywords: coronary artery disease; stent; bioresorbable; drug; polymer; strut The Evolution of Coronary Stent DevelopmentCoronary artery disease (CAD) is a major cause of mortality and morbidity. One of the treatment options for CAD is a percutaneous coronary intervention. Balloon angioplasty alone, which involves pushing the plaque to the walls of the artery, can achieve a larger luminal diameter in the acute phase. However, arterial recoil, dissection, and late neointimal hyperplasia can result in vessel restenosis. Therefore, bare metal stents (BMSs) made from metallic materials were developed to overcome the dissection and the restenosis complications caused by recoil. Although the restenosis rate can be reduced by stenting, the in-stent restenosis (ISR) rate is still high at around 20%-30% [1,2]. ISR is mostly caused by neointimal hyperplasia.A reduction in restenosis was first achieved with the evolution of the stent platform, including thinner stent struts and new metal compounds. Furthermore, new drug delivery systems and polymer coatings have been developed to achieve better clinical outcomes. The first generation of drug-eluting stents (DESs) with a sirolimus or paclitaxel coating showed better clinical outcomes with lower rates of cardiac death, myocardial infarction, and target vessel revascularization than BMSs [3,4]. However, increased rates of stent thrombosis were reported with first-generation

show abstract

Biodegradable polymer stentsvssecond generation drug eluting stents: A meta-analysis and systematic review of randomized controlled trials

Abstract: BD-DES, when compared to second generation PP-DES, showed no significant advantage and the outcomes were comparable between both the groups.

Cited by 16 publications

References 15 publications

Right coronary artery thrombosis within drug eluting stents more than 10 years after deployment: Two cases of very, very late stent thrombosis

Right coronary artery thrombosis within drug eluting stents more than 10 years after deployment: Two cases of very, very late stent thrombosis

A propensity score‐matched comparison of biodegradable polymer vs second‐generation durable polymer drug‐eluting stents in a real‐world population

The Development of Coronary Artery Stents: From Bare-Metal to Bio-Resorbable Types

Contact Info

Product

Resources

About