Biodegradable vs. permanent polymer drug-eluting stents: the need for a new nomenclature to classify drug-eluting stent technology

Häner, Jonas; Räber, Lorenz; Windecker, Stephan

doi:10.1093/eurheartj/ehz330

Cited by 10 publications

(3 citation statements)

References 14 publications

(12 reference statements)

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“…The most used DD schemes comprise polymer reservoir-based structures, pumps (peristaltic, infusion, and osmotic), and micro and nano electromechanical structures (MEMS and NEMS), see e.g., [79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94]. Reservoir structures utilize drug release by dispersion via a film structure.…”

Section: Implantable Drug Delivery Schemesmentioning

confidence: 99%

Image-Guided Surgical and Pharmacotherapeutic Routines as Part of Diligent Medical Treatment

Razek

2023

Applied Sciences

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This contribution is part of the objective of diligent universal care that ensures the well-being of a patient. It aims to analyze and propose enriched image-guided procedures for surgical interventions and restricted delivery of implanted drugs in minimally invasive and non-ionizing circumstances. This analysis is supported by a literature review conducted in two ways. The first aims to illustrate the importance of recent research and applications involved in different topics of the subject; this is mainly the case for the introduction’s literature. The second concerns the literature dedicated to having more detailed information in context; this mainly concerns the citations in the different sections of the article. The universal goals of medical treatments are intended to involve the well-being of the patient and allow medical personnel to test new therapies and carry out therapeutic training without risk to the patient. First, the various functionalities involved in these procedures and the concerns of the magnetic resonance imaging technique (MRI) and ultrasound imaging technique (USI), recent contributions to the subject are reviewed. Second, the intervention procedures guided by the image and the implemented actions are analyzed. Third, the components of the fields involved in MRI are examined. Fourth, the MRI control of the treatments, its performance and its compliance are analyzed. Compatibility with MRI via electromagnetic compatibility (EMC) is conferred and demonstrated for an actuation example. Fifth, the extension of the concepts mentioned in the article, in the context of patient comfort and the training of medical staff is proposed. The main contribution of this article is the identification of the different strategic aids needed in healthcare related to image-assisted robotics, non-ionized, minimally invasive and locally restrictive means. Furthermore, it highlights the benefits of using phantoms based on real biological properties of the body, digital twins under human control, artificial intelligence tools and augmented reality-assisted robotics.

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Section: Implantable Drug Delivery Schemesmentioning

confidence: 99%

Image-Guided Surgical and Pharmacotherapeutic Routines as Part of Diligent Medical Treatment

Razek

2023

Applied Sciences

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“…Although the diameter of plastic stents is small, it is easy to get restenosis due to biliary mud deposition in a very short time. 9,10 Thus, plastic stents often need to be replaced repeatedly under endoscopy, which is not only painful but also expensive and risky. 11,12 To deal with such issues, it is crucial to prevent the deposition of biliary mud in stents and prolong the patency time of plastic stents as much as possible.…”

Section: Introductionmentioning

confidence: 99%

Studying in vivo and in vitro effects of a novel polyvinyl benzyl chloride-D-glucaro-1, 4-lactonate polymer-coated bile duct stent for anti-biliary mud deposition

Zhang

Kanwal

Batool

et al. 2022

Journal of Applied Biomaterials & Functional Materials

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Background: We aim to coat a novel polyvinyl benzyl chloride-D-glucaro-1, 4-lactonate polymer-coated bile duct stent for anti-biliary mud deposition and investigate its in vivo and in vitro impacts. Biliary mud deposition is a leading cause of plastic biliary stent obstruction after its placement. Orally administrated D-glucaro-1, 4-lactonate is a specific competitive inhibitor of β-glucuronidase that causes biliary mud deposition. Methods: In this study, the stents coated with polyvinyl benzyl chloride-D-glucaro-1,4-lactonate polymer (PVBC-DGL) were placed in an ex vivo bile duct model perfused with porcine bile and observed every week until completely blocked. Post establishing the model of bile duct stenosis in piglets, stents are observed through endoscopy, hematology, patency time, and pathological changes within 6 months. Results: The 70% PVBC-DGL stents achieved the highest percentage of the inhibitory effect when the drugs were completely released in vitro. Results were obtained from 14 pigs (5: no coating (original), 4: 0% coating, and 5: 70% coating). The overall patency time of the stents was prolonged in all groups; however, the group with 70% coated stents showed a significantly prolonged patency time as compared to no coating (original) and the 0% coating groups in pigs (23.4 ± 1.8 vs 11.2 ± 2.1 w ( p = 0.05); 23.4 ± 1.8 vs 10.5 ± 2.5 w ( p = 0.05), respectively). Conclusion: The stents with 70% PVBC-DGL better prevent and control the deposition of bile mud and prolong the patency time of stent placement in the subject animals and may be proposed for further clinical trials in patients.

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“…Phenotypic switching can also underpin the pathogenesis of atherosclerosis, aortic aneurysm formation and hypertension [6,7,8]. While drug-eluting stents, and more recently, biodegradable drug-eluting stents, have improved clinical outcomes following PCI [9,10], challenges such as in-stent SMC hyperplasia, inadequate re-endothelialization and thrombosis remain [11,12]. Hence, a better understanding of molecular control in injured blood vessels and effective translation of this knowledge into the clinical arena is needed.…”

Section: Introductionmentioning

confidence: 99%

Transcription Factors Targeted by miRNAs Regulating Smooth Muscle Cell Growth and Intimal Thickening after Vascular Injury

Khachigian

2019

IJMS

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Neointima formation after percutaneous coronary intervention (PCI) is a manifestation of “phenotype switching” by vascular smooth muscle cells (SMC), a process that involves de-differentiation from a contractile quiescent phenotype to one that is richly synthetic. In response to injury, SMCs migrate, proliferate, down-regulate SMC-specific differentiation genes, and later, can revert to the contractile phenotype. The vascular response to injury is regulated by microRNAs (or miRNAs), small non-coding RNAs that control gene expression. Interactions between miRNAs and transcription factors impact gene regulatory networks. This article briefly reviews the roles of a range of miRNAs in molecular and cellular processes that control intimal thickening, focusing mainly on transcription factors, some of which are encoded by immediate-early genes. Examples include Egr-1, junB, KLF4, KLF5, Elk-1, Ets-1, HMGB1, Smad1, Smad3, FoxO4, SRF, Rb, Sp1 and c-Myb. Such mechanistic information could inform the development of strategies that block SMC growth, neointima formation, and potentially overcome limitations of lasting efficacy following PCI.

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Biodegradable vs. permanent polymer drug-eluting stents: the need for a new nomenclature to classify drug-eluting stent technology

Abstract: Abstract

Cited by 10 publications

References 14 publications

Image-Guided Surgical and Pharmacotherapeutic Routines as Part of Diligent Medical Treatment

Image-Guided Surgical and Pharmacotherapeutic Routines as Part of Diligent Medical Treatment

Studying in vivo and in vitro effects of a novel polyvinyl benzyl chloride-D-glucaro-1, 4-lactonate polymer-coated bile duct stent for anti-biliary mud deposition

Transcription Factors Targeted by miRNAs Regulating Smooth Muscle Cell Growth and Intimal Thickening after Vascular Injury

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