Role of stent design and coatings on restenosis and thrombosis

Hara, Hidehiko; Nakamura, Masato; Palmaz, Julio C.; Schwartz, Robert S.

doi:10.1016/j.addr.2006.01.022

Cited by 153 publications

(104 citation statements)

References 64 publications

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“…The high surface to volume ratio iron foils lead to implant fragmentation in the mouse tail within 6 to 9 months, which is close to the clinically favored period [41][42][43] . Other implant forms are expected to degrade more slowly.…”

Section: Molecular Characterization Of the Implant-tissue Interactionmentioning

confidence: 99%

Histological and molecular evaluation of iron as degradable medical implant material in a murine animal model

Mueller

Arnold

Badar

et al. 2012

J Biomedical Materials Res

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Section: Molecular Characterization Of the Implant-tissue Interactionmentioning

confidence: 99%

Histological and molecular evaluation of iron as degradable medical implant material in a murine animal model

Mueller

Arnold

Badar

et al. 2012

J Biomedical Materials Res

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“…3) However, there are several problems for the NiTi SMAs as biomedical materials: the hypersensitivity of Ni 4,5) and poor visibility in X-ray radiography. 6,7) Thus, our group has been developing AuTi-based biomedical SMAs which are composed of biocompatible elements Au and Ti. The high concentration of Au also brings high X-ray radiography.…”

Section: Introductionmentioning

confidence: 99%

Effect of Nb Addition on Martensitic Transformation Behavior of AuTi-15Co Based Biomedical Shape Memory Alloys

et al. 2015

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The effect of quaternary addition of Nb being from 0 to 2 mol% on the phase constitution, phase transformation behavior and shape memory behavior of Au-50 mol%Ti-15 mol%Co (AuTiCo) alloys is studied. X-ray diffraction analysis shows that, with increasing Nb concentration, the primary phase appeared at room temperature changes from B19 orthorhombic martensite phase to B2 cubic parent phase, and that all the lattice parameters are not largely changed by Nb addition. The maximum transformation strain evaluated in 2 mol%Nb-added AuTiCo is 7.4%. Differential scanning calorimetry revealed that the reverse martensitic transformation finish temperature (A f ) decreases from 414 K in Nb-free AuTiCo to 303 K by 2 mol%Nb addition. The ratio of A f change by Nb addition is evaluated to be ¹55 K/mol%Nb, that is comparably larger than ¹31 K/mol%Nb in NiTi. These results indicate that Nb addition is effective to stabilize B2 parent phase. AuTiCo alloy containing less than 2 mol%Nb exhibits shape memory effect with 90% shape recovery ratio. Besides, AuTiCo containing 2 mol%Nb exhibits 2.8% superelastic shape recovery at room temperature as well as 7.4% maximum transformation strain. Therefore, Nb addition to AuTiCo is effective to decrease the martensitic transformation temperature and to improve superelasticity, although the transformation temperature hysteresis increases by Nb addition, similar to Nb-added NiTi.

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“…Two main approaches have been adopted to reduce instent restenosis; (1) optimising the stent design to reduce vascular injury and hence subsequent neointimal hyperplasia [17,26], and (2) using anti-proliferative drug eluting stents to inhibit the growth of neointimal hyperplasia [8]. The delivery of an anti-proliferative drug to surrounding tissue is also significantly influenced by the stent design [11].…”

Section: Introductionmentioning

confidence: 99%

Determination of the influence of stent strut thickness using the finite element method: implications for vascular injury and in-stent restenosis

Zahedmanesh

Lally

2009

Med Biol Eng Comput

120

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Many clinical studies, including the ISAR-STEREO trial, have identified stent strut thickness as an independent predictor of in-stent restenosis where thinner struts result in lower restenosis than thicker struts. The aim of this study was to more conclusively identify the mechanical stimulus for in-stent restenosis using results from such clinical trials as the ISAR-STEREO trial. The mechanical environment in arteries stented with thin and thicker strut stents was investigated using numerical modelling techniques. Finite element models of the stents used in the ISAR-STEREO clinical trial were developed and the stents were deployed in idealised stenosed vessel geometries in order to compare the mechanical environment of the vessel for each stent. The stresses induced within the stented vessels by these stents were compared to determine the level of vascular injury caused to the artery by the stents with different strut thickness. The study found that when both stents were expanded to achieve the same initial maximum stent diameter that the thinner strut stent recoiled to a greater extent resulting in lower luminal gain but also lower stresses in the vessel wall, which is hypothesised to be responsible for the lower restenosis outcome. This study supports the hypothesis that arteries develop restenosis in response to injury, where high vessel stresses are a good measure of that injury. This study points to a critical stress level in arteries, above which an aggressive healing response leads to in-stent restenosis in stented vessels. Stents can be designed to reduce stresses in this range in arteries using preclinical tools such as numerical modelling.

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Role of stent design and coatings on restenosis and thrombosis

Cited by 153 publications

References 64 publications

Histological and molecular evaluation of iron as degradable medical implant material in a murine animal model

Histological and molecular evaluation of iron as degradable medical implant material in a murine animal model

Effect of Nb Addition on Martensitic Transformation Behavior of AuTi-15Co Based Biomedical Shape Memory Alloys

Determination of the influence of stent strut thickness using the finite element method: implications for vascular injury and in-stent restenosis

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