Stent Polymers

Rizas, Konstantinos D.; Mehilli, Julinda

doi:10.1161/circinterventions.115.002943

Cited by 64 publications

(24 citation statements)

References 63 publications

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“…In the last two decades, therefore, innovative stents from polymers [33,34] and degradable metals such as iron and magnesium were developed, which initially ensure the openness of the coronary vessel and are degraded without residue after a sufficient regeneration phase [35][36][37][38][39][40]. The coating of degradable metal stents should slow the corrosion [35].…”

Section: Coronary Heart Diseasementioning

confidence: 99%

Cardiovascular Applications of Magnesium Alloys

Schilling¹,

Bauer²,

LaLonde³

et al. 2017

Magnesium Alloys

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Therapy in cardiovascular medicine often relies on implantation of prosthetic materials or application of stents. The diseases of many cardiovascular structures require their complete and immediate repair by utilising prosthetic materials. The ideal cardiovascular prosthesis involves good functional properties, capability of regeneration and does not activate the host's immune system. Ideally, the graft can be applied for a temporary use and degrades after a predefined period according to controlled degradation kinetics. Only biological grafts would provide this spectrum of properties by today's level of knowledge. However, biological prostheses exhibit some relevant drawbacks as well, such as insufficient mechanical stability or restricted availability. Implants or supporting structures of magnesium alloys would bridge this gap and would either provide a substrate for innovative and temporary grafts or would-as supporting structures-transiently add some missing properties to regenerative biological prostheses. This chapter reviews the different fields of cardiovascular therapeutic applications of magnesium alloys. The required properties of magnesium alloys and their preparation, fabrication and testing will be discussed under the specific cardiovascular perspective.

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Section: Coronary Heart Diseasementioning

confidence: 99%

Cardiovascular Applications of Magnesium Alloys

Schilling¹,

Bauer²,

LaLonde³

et al. 2017

Magnesium Alloys

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“…The half-life of these drugs is very short, but the length of antiproliferative effect that is necessary to prevent restenosis is long. Therefore, for a DES to prevent restenosis, there must be a long, controlled elution of the anti-proliferative drug from the metallic backbone so as to ensure its presence over an extended period of time [ 22 , 23 ]. This mission is accomplished using a carrier vehicle like a polymer.…”

Section: Balloon Expandable Stentsmentioning

confidence: 99%

“…This mission is accomplished using a carrier vehicle like a polymer. An ideal polymer must be biocompatible, not interact with the active restenotic drug, release the drug at the proper rate, and be biologically inert and mechanically stable over the long term [ 23 ]. Durable, non-degradable polymers have been used historically and, more recently, polymer free elution methods and biodegradable polymers have been developed [ 23 ].…”

Section: Balloon Expandable Stentsmentioning

confidence: 99%

“…The polymers have become more biocompatible over the years. Initially polyethylene- co -vinyl-acetate (PEVA) and poly- n -butyl-methacrylate were used in the Cypher stent, and poly (styrene-b-isobutylene-b-styrene) was used in the Taxus stent [ 23 ]. The current drug eluting stents have more biocompatible polymers, such as poly-vinylidene fluoride, hexofluropropylene, and polyvinyl pyrollidone [ 23 ].…”

Section: Balloon Expandable Stentsmentioning

confidence: 99%

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Coronary Stents: History, Design, and Construction

Schmidt

Abbott

2018

JCM

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The history of percutaneous coronary intervention (PCI) is marked by rapid technological advancements that have taken place over the past 40 years. 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. The introduction of drug eluting stents (DES) targeted in-stent restenosis, a common mode of stent failure, and ushered in the current PCI era. Since the first generation of DES, advances in polymer science and stent design have advanced the field. The current generation of DES has thin struts, are highly deliverable, have biocompatible or absorbable polymers, and outstanding safety and efficacy profiles. In this review, we discuss the technological advancements in stent development, design, and construction, with an emphasis on balloon expandable stents. The aspects of stent properties, metal alloys, bioresorbable vascular scaffolds, drug elution, and polymers will be covered.

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“…For this purpose, polymer-based coatings are largely used in most DES. Polymer drug reservoirs should share the following characteristics: (i) be biocompatible, (ii) do not interact with the active drug, (iii) provide a platform for appropriate drug-eluting kinetics, (iv) behave in a biologically inert manner after the drug has been completely eluted, and (v) be mechanically stable over the long-term in the dynamics of coronary circulation milieu [ 17 ]. However, the durable polymer (DP) used in 1st-generation SES, poly-( n )-butyl methacrylate, was considered a trigger for late clinical adverse events via chronic hypersensitivity, demonstrating that other polymers do not have these characteristics.…”

Section: Drug and Polymermentioning

confidence: 99%

Understanding the Impact of Stent and Scaffold Material and Strut Design on Coronary Artery Thrombosis from the Basic and Clinical Points of View

et al. 2018

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The technology of percutaneous coronary intervention (PCI) is constantly being refined in order to overcome the shortcomings of present day technologies. Even though current generation metallic drug-eluting stents (DES) perform very well in the short-term, concerns still exist about their long-term efficacy. Late clinical complications including late stent thrombosis (ST), restenosis, and neoatherosclerosis still exist and many of these events may be attributed to either the metallic platform and/or the drug and polymer left behind in the arterial wall. To overcome this limitation, the concept of totally bioresorbable vascular scaffolds (BRS) was invented with the idea that by eliminating long-term exposure of the vessel wall to the metal backbone, drug, and polymer, late outcomes would improve. The Absorb-bioabsorbable vascular scaffold (Absorb-BVS) represented the most advanced attempt to make such a device, with thicker struts, greater vessel surface area coverage and less radial force versus contemporary DES. Unfortunately, almost one year after its initial approval by the U.S. Food and Drug Administration, this scaffold was withdrawn from the market due to declining devise utilization driven by the concerns about scaffold thrombosis (ScT) seen in both early and late time points. Additionally, the specific causes of ScT have not yet been fully elucidated. In this review, we discuss the platform, vascular response, and clinical data of past and current metallic coronary stents with the Absorb-BVS and newer generation BRS, concentrating on their material/design and the mechanisms of thrombotic complications from the pre-clinical, pathologic, and clinical viewpoints.

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Stent Polymers

Cited by 64 publications

References 63 publications

Cardiovascular Applications of Magnesium Alloys

Cardiovascular Applications of Magnesium Alloys

Coronary Stents: History, Design, and Construction

Understanding the Impact of Stent and Scaffold Material and Strut Design on Coronary Artery Thrombosis from the Basic and Clinical Points of View

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