Update on Bioabsorbable Stents: From Bench to Clinical

Abstract

Permanent metallic stents are associated with limitations such as continued mechanical stress, transfer to the tissue, and continued biological interaction with the surrounding tissue. They are also associated with late stent thrombosis and artifacts when non-invasive technologies such as MRI and MSCT are used. The potential advantages of bioabsorbable polymeric or metallic stents are to leave no stent behind, they are fully compatible with MRI and MSCT imaging, and are not associated with late stent thrombosis. This review covers the different stent programs as they move from bench to bed and clinical trials. Bioabsorbable stents are considered the next frontier of stenting and we will discuss their potential to fulfill this promise in interventional cardiology.

Stent-Assisted Reconstructive Endovascular Repair of Cranial Fusiform Atherosclerotic and Dissecting Aneurysms

“…Great care is necessary to preserve perforators that exit from the stented arterial segment during aneurysm embolization by segmented coiling, the use of nondetachable balloons, or more recently steerable microcatheters. As discussed in the coronary literature, 43 future development of absorbable stents should be considered to prevent permanent jailing of important perforators. Experience in cardiology teaches that it may be important to place patients on dual antiplatelet therapy to prevent thrombotic events.…”

Guided bone regeneration using a hydrophilic membrane made of unsintered hydroxyapatite and poly(L-lactic acid) in a rat bone-defect model

“…Poly(L-lactic acid) (PLLA) or poly(lactic-co-glycolic acid) (PLGA) is a synthetic biodegradable polymer that is also used as a material for biodegradable medical membrane 23,24) . It does not trigger the infections and immune responses characteristic of animal-derived biomaterials, and thus use of PLLA as a biomedical material has been widely studied in the areas of bone healing materials, tissue engineering, and drug delivery.…”

Current status of infrapopliteal artery stenting in patients with critical limb ischemia

“…Based on emerging evidence, many cardiologists are recommending a minimum of 12 months of aspirin and clopidogrel, but some are advocating indefinite use of dual antiplatelet therapy after DES implantation. 21 One year of clopidogrel costs approximately US$1,000.00. This expense is in addition to the cost already incurred by using a DES, which is usually fourfold greater than the bare metal equivalent; one coronary BMS costs US$800.00 while one DES costs up to US$ 2,500.00 22 ( Figure 4).…”

“…Recently, the stenting technology has moved towards the development of temporary implants composed of biocompatible materials which mechanically support the vessel during the period of high risk for recoil and then completely degrade on the long-term. 21,[27][28][29] Therefore, bioabsorbable stents are regarded as a means of combining mechanical prevention of vessel recoil with various long-term advantages, when compared with permanent implants, including the possibility of late outward vessel remodeling and improved reintervention options. 28 The bioabsorbable magnesium-alloy stent (AMS) (Biotronik AG, Bülach, Switzerland) was the first of its kind to be proved that it could be implanted safely in human arteries and that it was absorbed as intended.…”