1
|
Udriște AS, Burdușel AC, Niculescu AG, Rădulescu M, Grumezescu AM. Coatings for Cardiovascular Stents-An Up-to-Date Review. Int J Mol Sci 2024; 25:1078. [PMID: 38256151 PMCID: PMC10817058 DOI: 10.3390/ijms25021078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Cardiovascular diseases (CVDs) increasingly burden health systems and patients worldwide, necessitating the improved awareness of current treatment possibilities and the development of more efficient therapeutic strategies. When plaque deposits narrow the arteries, the standard of care implies the insertion of a stent at the lesion site. The most promising development in cardiovascular stents has been the release of medications from these stents. However, the use of drug-eluting stents (DESs) is still challenged by in-stent restenosis occurrence. DESs' long-term clinical success depends on several parameters, including the degradability of the polymers, drug release profiles, stent platforms, coating polymers, and the metals and their alloys that are employed as metal frames in the stents. Thus, it is critical to investigate new approaches to optimize the most suitable DESs to solve problems with the inflammatory response, delayed endothelialization, and sub-acute stent thrombosis. As certain advancements have been reported in the literature, this review aims to present the latest updates in the coatings field for cardiovascular stents. Specifically, there are described various organic (e.g., synthetic and natural polymer-based coatings, stents coated directly with drugs, and coatings containing endothelial cells) and inorganic (e.g., metallic and nonmetallic materials) stent coating options, aiming to create an updated framework that would serve as an inception point for future research.
Collapse
Affiliation(s)
- Alexandru Scafa Udriște
- Department 4 Cardio-Thoracic Pathology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Alexandra Cristina Burdușel
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania; (A.C.B.); (A.-G.N.); (A.M.G.)
| | - Adelina-Gabriela Niculescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania; (A.C.B.); (A.-G.N.); (A.M.G.)
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
| | - Marius Rădulescu
- Department of Inorganic Chemistry, Physical Chemistry and Electrochemistry, University Politehnica of Bucharest, 1-7 Polizu St., 011061 Bucharest, Romania
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania; (A.C.B.); (A.-G.N.); (A.M.G.)
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
| |
Collapse
|
2
|
Sahu RA, Nashine A, Mudey A, Sahu SA, Prasad R. Cardiovascular Stents: Types and Future Landscape. Cureus 2023; 15:e43438. [PMID: 37711918 PMCID: PMC10499059 DOI: 10.7759/cureus.43438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023] Open
Abstract
One of the prominent reasons for mortality and morbidity worldwide is coronary artery disease (CAD), an ailment that manifests itself by the narrowing of the artery with the deposition of plaque. The definitive mode of action for dealing with this condition is using a medical device known as a stent at the affected location. This extremely important tubular equipment helps tremendously with vessel support. It also helps by keeping the path of blood flow clear for the heart muscle masses, its crucial nutrients, and oxygen supply. Several generations of stents have been continuously developed to improve patient outcomes and reduce side effects post-stent implantation. As we move from bare metal stents (BMSs) to drug-eluting stents (DESs) and, more recently, to bioabsorbable stents, the research area continues to develop. The use of this biomedical device has increased the standard of living in many cases; therefore, it is much needed to work on the possible growth areas in the cardiovascular stents and improve them to such an extent that the patients suffering from cardiovascular ailments get to live a comfortable life. Most articles deal with stents that are available for current use and their various types. They also cover the topic of stent optimization, as it is one of the key factors in enhancing stent usability and plays a prominent role in optimizing stent placement in the vessels of the body. To keep in touch with advances in stent technology over the past few decades, this article reviews advances in the devices, working on how available stents can be optimized to create new stents.
Collapse
Affiliation(s)
- Rohit A Sahu
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aparna Nashine
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Abhay Mudey
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shreya A Sahu
- Obstretics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Roshan Prasad
- Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
3
|
Ishihara R. Endoscopic Stenting for Malignant Dysphagia in Patients with Esophageal Cancer. Curr Oncol 2023; 30:5984-5994. [PMID: 37504308 PMCID: PMC10378447 DOI: 10.3390/curroncol30070447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/09/2023] [Accepted: 06/17/2023] [Indexed: 07/29/2023] Open
Abstract
Malignant dysphagia is a common problem in patients with esophageal cancer. Endoscopic stenting can resolve dysphagia caused by malignant stricture; however, controversy exists regarding the use of esophageal stenting for the treatment of malignant stricture, including whether stenting or radiotherapy is superior, whether stenting before or after radiotherapy is safe, whether stenting before or after chemotherapy is safe, and whether low-radial-force stents are safer than conventional stents. Among treatment options for malignant dysphagia, stenting may have some disadvantages in terms of pain relief and the risk of adverse events compared with radiotherapy and in terms of survival compared with gastrostomy. Additionally, the risk of stent-related adverse events is significantly associated with prior radiotherapy. The risk of perforation is especially high when a radiation dose of >40 Gy is delivered to the esophagus after stenting, whereas perforation is not associated with prior chemotherapy or additional chemotherapy after stenting. Nevertheless, stenting remains an important palliative option, especially for patients with a short life expectancy and a strong desire for oral intake, because stenting can facilitate a more rapid improvement in dysphagia than radiotherapy or gastrostomy. The application of a low-radial-force stent should be considered to reduce the risk of adverse events, especially in patients with prior radiotherapy.
Collapse
Affiliation(s)
- Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka 541-8567, Japan
| |
Collapse
|
4
|
Glushchenko L, Hubbard B, Sedush N, Shchepochkin V, Krupnin A, Sharafeev A. Novel Self-expanding Shape-Memory Bioresorbable Peripheral Stent Displays Efficient Delivery, Accelerated Resorption, and Low Luminal Loss in a Porcine Model. J Endovasc Ther 2023; 30:140-147. [PMID: 35142226 PMCID: PMC9896407 DOI: 10.1177/15266028221077001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE AND DESIGN The search for improved stenting technologies to treat peripheral artery disease is trending toward biodegradable self-expanding shape-memory stents that, as of now, still suffer from the acute trade-off between deliverability and luminal stability: Higher deliverability leads to lower lumen stability, vessel recoil, and stent breakage. This study was aimed at the development and testing of a self-expanding bioresorbable poly(l,l-lactide-co-ε-caprolactone) stent that was designed to produce confident self-expansion after efficient crimping, as well as quick bioresorption, and sufficient radial force. MATERIALS AND METHODS Bench tests were employed to measure shape-memory properties, radial force, and hydrolytic degradation of the stent. The porcine model was employed to study deliverability, lumen stability, biocompatibility, and stent integrity. A total of 32 stents were implanted in the iliac arteries of 16 pigs with 15 to 180 day follow-up periods. The stented vessels were studied by angiography and histological evaluation. RESULTS Recovery of the diameter of the stent due to shape-memory effect was equal to 90.6% after 6Fr crimping and storage in refrigeration for 1 week. Radial force measured after storage was equal to 0.7 N/mm. Technical success of implantation in pigs (after the delivery implemented by pusher) was 94%. At 180 days, no implanted stents were found to be fragmented: All of the devices remained at the site of implantation with no stent migration and all stents retained their luminal support. Only moderate inflammation and neoepithelialization were detected by histological assessment at 60, 90, 120, and 180 days. Lumen loss at 180 days was less than 25% of the vessel diameter. CONCLUSIONS The stent with the mechanical and chemical properties described in this study may present the optimal solution of the trade-off between deliverability and luminal stability that is necessary for designing the next generation stent for endovascular therapy of peripheral arterial disease.
Collapse
Affiliation(s)
- Leonid Glushchenko
- Resotech Medical Solutions Corp,
Delaware, USA,Leonid Glushchenko, Resotech Medical
Solutions Corp, 51 Little Falls Drive, the City of Wilmington, County of New
Castle, Delaware, 19808, USA.
| | - Brad Hubbard
- Pathway Preclinical Services,
Minneapolis, MN, USA
| | | | | | | | | |
Collapse
|
5
|
Kumari G, Abhishek K, Singh S, Hussain A, Altamimi MA, Madhyastha H, Webster TJ, Dev A. A voyage from 3D to 4D printing in nanomedicine and healthcare: part II. Nanomedicine (Lond) 2022; 17:255-270. [PMID: 35109687 DOI: 10.2217/nnm-2021-0454] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Recent advancements in biomedical tissue engineering are gaining wide interest. Implementing biology of living cells and organisms using technological solutions such as incorporating 4D printing and bioprinting for tissue regeneration/tissue repair, organ regeneration, early diagnosis of deadly diseases (particularly cancer, cardiac disorders and tuberculosis) has successfully opened a new generation of biomedical research. The present review primarily addresses the clinical application of 4D printing and bioprinting techniques for applications such as early detection of diseases and drug delivery. Notably, this review continues the discussion from part I regarding published informative data, in vitro and in vivo findings, commercial biosensors for early disease diagnosis, drug delivery and current challenges in 4D printing/bioprinting.
Collapse
Affiliation(s)
- Gourvi Kumari
- Department of Pharmaceutical Sciences & Technology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, 835215, India
| | - Kumar Abhishek
- Department of Pharmaceutical Sciences & Technology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, 835215, India
| | - Sneha Singh
- Department of Bioengineering and Biotechnology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, 835215, India
| | - Afzal Hussain
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Saudi Arabia
| | - Mohammad A Altamimi
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Saudi Arabia
| | - Harishkumar Madhyastha
- Department of Cardiovascular Physiology, School of Medicine, University of Miyazaki, Miyazaki, 889 1692, Japan
| | - Thomas J Webster
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Abhimanyu Dev
- Department of Pharmaceutical Sciences & Technology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, 835215, India
| |
Collapse
|
6
|
He R, Zhao L, Silberschmidt VV, Feng J, Serracino-Inglott F. Personalised nitinol stent for focal plaques: Design and evaluation. J Biomech 2021; 130:110873. [PMID: 34883344 DOI: 10.1016/j.jbiomech.2021.110873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/01/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
The purpose of this study is to develop personalised nitinol stents for arteries with one and two opposite focal plaques. Novel designs are evaluated through comparison with a commercial stent design, in terms of lumen gain and shape as well as stress levels in the media layer after stenting. METHODS Personalised stents are developed for arteries with one and two opposite focal plaques, based on medical imaging of patients and computer simulations. In silico analysis is then carried out for assessment of stent performance in the diseased arteries. RESULTS Personalised designs significantly increase the lumen gain, reduce the stresses in the media layer, and improve the lumen shape compared to the commercial nitinol stent. CONCLUSION The personalised designs show outstanding performance compared to the commercial stent. SIGNIFICANCE This pilot study proves that personalised nitinol stents are able to deliver desirable treatment outcomes.
Collapse
Affiliation(s)
- Ran He
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK.
| | - Liguo Zhao
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK
| | - Vadim V Silberschmidt
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK
| | - Jiling Feng
- Department of Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK
| | | |
Collapse
|
7
|
Pioneering personalised design of femoropopliteal nitinol stents. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 130:112462. [PMID: 34702537 DOI: 10.1016/j.msec.2021.112462] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND/MOTIVATION Percutaneous femoropopliteal artery intervention moves towards personalised therapy, which requires design of unique lesion-specific stents. However, to date, not much progress has been made in the development of personalised stents. OBJECTIVE This paper aims to design personalised nitinol stents for femoropopliteal arteries based on medical imaging of patients and advanced computational mechanics, which is the first attempt to the authors' best knowledge. METHODS The design process is based on three objectives: (i) achieving the healthy lumen area; (ii) reducing the stress in the media layer; (iii) improving the lumen shape after stenting. The design parameters include the strut width and thickness, the crown length, the nominal radius and the number of strut units per crown. Using representative unit-cell models, the effects of the five geometric parameters on the stent performance are investigated thoroughly with numerical simulations. Then, design protocols, especially for the circumferentially varying strut size and the oval stent shape, are developed and fully evaluated for an asymmetric stenosis. RESULTS Using the design protocols, full personalised stents are designed for arteries with diffuse and focal plaques, based on medical imaging of patients. The personalised stent designs provide a double lumen gain, a reduced stress in the media layer and an improved lumen shape compared to a commercial stent. CONCLUSIONS The suggested protocols prove their high effectiveness in design of personalised stents, and the suggested approach can be applied to development of personalised therapies involving the use of stent technology including percutaneous coronary artery intervention, transcatheter aortic valve implantation, endovascular aneurysm repair and ureteric stenting.
Collapse
|
8
|
Scafa Udriște A, Niculescu AG, Grumezescu AM, Bădilă E. Cardiovascular Stents: A Review of Past, Current, and Emerging Devices. MATERIALS (BASEL, SWITZERLAND) 2021; 14:2498. [PMID: 34065986 PMCID: PMC8151529 DOI: 10.3390/ma14102498] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022]
Abstract
One of the leading causes of morbidity and mortality worldwide is coronary artery disease, a condition characterized by the narrowing of the artery due to plaque deposits. The standard of care for treating this disease is the introduction of a stent at the lesion site. This life-saving tubular device ensures vessel support, keeping the blood-flow path open so that the cardiac muscle receives its vital nutrients and oxygen supply. Several generations of stents have been iteratively developed towards improving patient outcomes and diminishing adverse side effects following the implanting procedure. Moving from bare-metal stents to drug-eluting stents, and recently reaching bioresorbable stents, this research field is under continuous development. To keep up with how stent technology has advanced in the past few decades, this paper reviews the evolution of these devices, focusing on how they can be further optimized towards creating an ideal vascular scaffold.
Collapse
Affiliation(s)
- Alexandru Scafa Udriște
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.S.U.); (E.B.)
- Cardiology Department, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
| | - Adelina-Gabriela Niculescu
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, 060042 Bucharest, Romania;
| | - Alexandru Mihai Grumezescu
- Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 060042 Bucharest, Romania
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
| | - Elisabeta Bădilă
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.S.U.); (E.B.)
- Internal Medicine Department, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
| |
Collapse
|
9
|
Fouladian P, Jin Q, Arafat M, Song Y, Guo X, Blencowe A, Garg S. Drug-Loaded, Polyurethane Coated Nitinol Stents for the Controlled Release of Docetaxel for the Treatment of Oesophageal Cancer. Pharmaceuticals (Basel) 2021; 14:ph14040311. [PMID: 33915787 PMCID: PMC8067330 DOI: 10.3390/ph14040311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 12/18/2022] Open
Abstract
For several decades, self-expanding metal stents (SEMSs) have shown significant clinical success in the palliation of obstructive metastatic oesophageal cancer. However, these conventional oesophageal stents can suffer from stent blockage caused by malignant tumour cell growth. To overcome this challenge, there is growing interest in drug-releasing stents that, in addition to palliation, provide a sustained and localized release of anticancer drugs to minimise tumour growth. Therefore, in this study we prepared and evaluated an oesophageal stent-based drug delivery platform to provide the sustained release of docetaxel (DTX) for the treatment of oesophageal cancer-related obstructions. The DTX-loaded oesophageal stents were fabricated via dip-coating of bare nitinol stents with DTX-polyurethane (PU) solutions to provide PU coated stents with DTX loadings of 1.92 and 2.79% w/w. Mechanical testing of the DTX-PU coated stents revealed that an increase in the drug loading resulted in a reduction in the ultimate tensile strength, toughness and Young’s modulus. In vitro release studies showed a sustained release of DTX, with ~80–90% released over a period of 33 days. While the DTX-loaded stents exhibited good stability to gamma radiation sterilisation, UV sterilisation or accelerated storage at elevated temperatures (40 °C) resulted in significant DTX degradation. Cell proliferation, apoptosis and Western blotting assays revealed that the DTX released from the stents had comparable anticancer activity to pure DTX against oesophageal cancer cells (KYSE-30). This research demonstrates that the dip-coating technique can be considered as a promising approach for the fabrication of drug-eluting stents (DESs) for oesophageal cancer treatment.
Collapse
Affiliation(s)
- Paris Fouladian
- Pharmaceutical Innovation and Development (PIDG) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; (P.F.); (M.A.); (Y.S.)
| | - Qiuyang Jin
- Key Laboratory of Chemical Biology (Ministry of Education), Department of Pharmacology, School of Pharmaceutical Sciences, Shandong University, Jinan 250012, China;
| | - Mohammad Arafat
- Pharmaceutical Innovation and Development (PIDG) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; (P.F.); (M.A.); (Y.S.)
| | - Yunmei Song
- Pharmaceutical Innovation and Development (PIDG) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; (P.F.); (M.A.); (Y.S.)
| | - Xiuli Guo
- Key Laboratory of Chemical Biology (Ministry of Education), Department of Pharmacology, School of Pharmaceutical Sciences, Shandong University, Jinan 250012, China;
- Correspondence: (X.G.); (A.B.); (S.G.)
| | - Anton Blencowe
- Applied Chemistry and Translational Biomaterials (ACTB) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
- Correspondence: (X.G.); (A.B.); (S.G.)
| | - Sanjay Garg
- Pharmaceutical Innovation and Development (PIDG) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; (P.F.); (M.A.); (Y.S.)
- Correspondence: (X.G.); (A.B.); (S.G.)
| |
Collapse
|
10
|
Cockerill I, See CW, Young ML, Wang Y, Zhu D. Designing Better Cardiovascular Stent Materials - A Learning Curve. ADVANCED FUNCTIONAL MATERIALS 2021; 31:2005361. [PMID: 33708033 PMCID: PMC7942182 DOI: 10.1002/adfm.202005361] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 05/07/2023]
Abstract
Cardiovascular stents are life-saving devices and one of the top 10 medical breakthroughs of the 21st century. Decades of research and clinical trials have taught us about the effects of material (metal or polymer), design (geometry, strut thickness, and the number of connectors), and drug-elution on vasculature mechanics, hemocompatibility, biocompatibility, and patient health. Recently developed novel bioresorbable stents are intended to overcome common issues of chronic inflammation, in-stent restenosis, and stent thrombosis associated with permanent stents, but there is still much to learn. Increased knowledge and advanced methods in material processing have led to new stent formulations aimed at improving the performance of their predecessors but often comes with potential tradeoffs. This review aims to discuss the advantages and disadvantages of stent material interactions with the host within five areas of contrasting characteristics, such as 1) metal or polymer, 2) bioresorbable or permanent, 3) drug elution or no drug elution, 4) bare or surface-modified, and 5) self-expanding or balloon-expanding perspectives, as they relate to pre-clinical and clinical outcomes and concludes with directions for future studies.
Collapse
Affiliation(s)
- Irsalan Cockerill
- Department of Biomedical Engineering, University of North Texas, Denton, TX 76207, USA
- Department of Materials Science and Engineering, University of North Texas, Denton, TX 76207, USA
| | - Carmine Wang See
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Marcus L. Young
- Department of Materials Science and Engineering, University of North Texas, Denton, TX 76207, USA
| | - Yadong Wang
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| |
Collapse
|
11
|
Influence of Polymer Composition on the Controlled Release of Docetaxel: A Comparison of Non-Degradable Polymer Films for Oesophageal Drug-Eluting Stents. Pharmaceutics 2020; 12:pharmaceutics12050444. [PMID: 32403329 PMCID: PMC7284596 DOI: 10.3390/pharmaceutics12050444] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 12/13/2022] Open
Abstract
Following the huge clinical success of drug-eluting vascular stents, there is a significant interest in the development of drug-eluting stents for other applications, such as the treatment of gastrointestinal (GI) cancers. Central to this process is understanding how particular drugs are released from stent coatings, which to a large extent is controlled by drug-polymer interactions. Therefore, in this study we investigated the release of docetaxel (DTX) from a selection of non-degradable polymer films. DTX-polymer films were prepared at various loadings (1, 5 and 10% w/w) using three commercially available polymers including poly(dimethylsiloxane) (PSi), poly (ethylene-co-vinyl acetate) (PEVA) and Chronosil polyurethane (PU). The formulations were characterised using different techniques such as photoacoustic Fourier-transform infrared (PA-FTIR) spectrophotometry, X-ray diffraction (XRD) and differential scanning calorimetry (DSC). The effect of DTX on the mechanical properties of the films, in-vitro release, and degradation tests were also assessed. For all polymers and DTX loadings, the drug was found to disperse homogenously without crystallisation within the polymer matrix. While no specific interactions were observed between DTX and PSi or PEVA, hydrogen-bonding appeared to be present between DTX and PU, which resulted in a concentration-dependent decrease in the Young’s moduli of the films due to disruption of inter-polymeric molecular interactions. In addition, the DTX-PU interactions were found to modulate drug release, providing near-linear release over 30 days, which was accompanied by a significant reduction in degradation products. The results indicate that DTX-loaded PU films are excellent candidates for drug-eluting stents for the treatment of oesophageal cancer.
Collapse
|
12
|
Bil M, Kijeńska-Gawrońska E, Głodkowska-Mrówka E, Manda-Handzlik A, Mrówka P. Design and in vitro evaluation of electrospun shape memory polyurethanes for self-fitting tissue engineering grafts and drug delivery systems. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 110:110675. [PMID: 32204102 DOI: 10.1016/j.msec.2020.110675] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 12/11/2022]
Abstract
Integration of multiple features including shape memory, biodegradation, and sustained drug delivery in a single material offers the opportunity to significantly improve the abilities of implantable devices for cardiovascular system regeneration. Two types of shape memory polyurethanes (SMPUs): PU-PLGA and PU-PLLA/PEG differing in soft segments composition that comprising blends of various biodegradable polyols, i.e. D,l-lactide-co-glycolide diol (o-PLGA), poly(e-caprolactone) diols (o-PCL) with various molecular weights, poly-l-lactide diol (o-PLLA), polyethylene glycol (o-PEG) were synthesized and further utilized to electrospun nanofibrous - rapamycin (Rap) delivery system. Structure characterization by Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DCS) and hydrophilicity measurements were performed to gain more insights on the influence of the particular units of the softs segments on the transition temperature (Ttrans), shape recovery, degradation profile, and drug release kinetics. In vitro study in PBS solution revealed that incorporation of o-PLGA segments to SMPUs is favorable over o-PEG as increased shape memory performance was observed. Moreover, presence of PLGA in PU-PLGA gave more predictable degradation profile in comparison to PU-PLLA/PEG system. Human Cardiac Fibroblasts (HCF) viability tests in vitro confirmed that the amount of Rap released from evaluated PU-PLLA/PEG/Rap and PU-PLGA/Rap drug delivery systems was sufficient to inhibit cells growth on the surface of the tested materials.
Collapse
Affiliation(s)
- Monika Bil
- Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, 141 Woloska Street, 02-507 Warsaw, Poland.
| | - Ewa Kijeńska-Gawrońska
- Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, 141 Woloska Street, 02-507 Warsaw, Poland
| | - Eliza Głodkowska-Mrówka
- Department of Experimental Hematology, Department of Laboratory Medicine, Institute of Hematology and Transfusion Medicine, 5 Indiry Gandhi Str, 02-776 Warsaw, Poland
| | - Aneta Manda-Handzlik
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, 63A Żwirki i Wigury Street, 02-091 Warsaw, Poland
| | - Piotr Mrówka
- Department of Biophysics and Human Physiology, Medical University of Warsaw, 5 Chalubinskiego Str., 02-004 Warsaw, Poland
| |
Collapse
|
13
|
Blair RW, Dunne NJ, Lennon AB, Menary GH. Multi-objective optimisation of material properties and strut geometry for poly(L-lactic acid) coronary stents using response surface methodology. PLoS One 2019; 14:e0218768. [PMID: 31449528 PMCID: PMC6709949 DOI: 10.1371/journal.pone.0218768] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 08/10/2019] [Indexed: 11/29/2022] Open
Abstract
Coronary stents for treating atherosclerosis are traditionally manufactured from metallic alloys. However, metal stents permanently reside in the body and may trigger undesirable immunological responses. Bioresorbable polymer stents can provide a temporary scaffold that resorbs once the artery heals but are mechanically inferior, requiring thicker struts for equivalent radial support, which may increase thrombosis risk. This study addresses the challenge of designing mechanically effective but sufficiently thin poly(L-lactic acid) stents through a computational approach that optimises material properties and stent geometry. Forty parametric stent designs were generated: cross-sectional area (post-dilation), foreshortening, stent-to-artery ratio and radial collapse pressure were evaluated computationally using finite element analysis. Response surface methodology was used to identify performance trade-offs by formulating relationships between design parameters and response variables. Multi-objective optimisation was used to identify suitable stent designs from approximated Pareto fronts and an optimal design is proposed that offers comparable performance to designs in clinical practice. In summary, a computational framework has been developed that has potential application in the design of high stiffness, thin strut polymeric stents.
Collapse
Affiliation(s)
- Ross W. Blair
- School of Mechanical and Aerospace Engineering, Queen’s University, Belfast, United Kingdom
- * E-mail:
| | - Nicholas J. Dunne
- School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin, Ireland
- Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin, Ireland
- School of Pharmacy, Queen’s University, Belfast, United Kingdom
- Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, Ireland
| | - Alex B. Lennon
- School of Mechanical and Aerospace Engineering, Queen’s University, Belfast, United Kingdom
| | - Gary H. Menary
- School of Mechanical and Aerospace Engineering, Queen’s University, Belfast, United Kingdom
| |
Collapse
|
14
|
Fabrication and Characterization of Bioresorbable Drug-coated Porous Scaffolds for Vascular Tissue Engineering. MATERIALS 2019; 12:ma12091438. [PMID: 31052587 PMCID: PMC6539797 DOI: 10.3390/ma12091438] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/24/2019] [Accepted: 04/28/2019] [Indexed: 02/03/2023]
Abstract
Bioresorbable polymers have been studied for several decades as attractive candidates for promoting the advancement of medical science and bio-technology in modern society. In particular, with a well-defined architecture, bioresorbable polymers have prominent advantages over their bulk counterparts for applications in biomedical and implant devices, such as cell delivery, scaffolds for tissue engineering, and hydrogels as well as in the pharmaceutical fields. Biocompatible implant devices based on bioresorbable materials (for instance, bioresorbable polymers that combine the unique advantages of biocompability and easy handling) have emerged as a highly active field due to their promising applications in artificial implant systems and biomedical devices. In this paper, we report an approach to fabricate porous polycaprolactone (PCL) scaffolds using a 3D printing system. And its surface was treated to a hydrophilic surface using plasma treatment. Then, the aspirin and atorvastatin calcium salt mixture was dip coated onto the surface. The drug coating technology was used to deposit the drug material onto the scaffold surface. Our porous PCL scaffold was coated with aspirin and atorvastatin calcium salt to reduce the blood LDL cholesterol and restenosis. These results suggest that our approach may provide a promising scaffold for developing bioresorbable drug-delivery-biomaterials. We further demonstrate that our bioresorbable medical device can be used as vascular scaffolds to provide a wide range of applications for the design of medical devices.
Collapse
|
15
|
Edelman ER, Wang PJ. Needles in Our Technology Haystacks: Defining Efficacy Is Easy, Characterizing Complications Is the Challenge. Circ Cardiovasc Interv 2017; 10:CIRCINTERVENTIONS.117.006059. [PMID: 29146674 DOI: 10.1161/circinterventions.117.006059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Pei-Jiang Wang
- From the Massachusetts Institute of Technology, Cambridge
| |
Collapse
|
16
|
Li J, Nemes P, Guo J. Mapping intermediate degradation products of poly(lactic‐
co
‐glycolic acid)
in vitro. J Biomed Mater Res B Appl Biomater 2017; 106:1129-1137. [DOI: 10.1002/jbm.b.33920] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 03/31/2017] [Accepted: 04/22/2017] [Indexed: 01/25/2023]
Affiliation(s)
- Jian Li
- Division of BiologyChemistry and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Office of Medical Products and Tobacco, U.S. Food and Drug AdministrationSilver Spring Maryland20993
| | - Peter Nemes
- Division of BiologyChemistry and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Office of Medical Products and Tobacco, U.S. Food and Drug AdministrationSilver Spring Maryland20993
| | - Ji Guo
- Division of BiologyChemistry and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Office of Medical Products and Tobacco, U.S. Food and Drug AdministrationSilver Spring Maryland20993
| |
Collapse
|
17
|
Abstract
Delivery of drugs onto arterial targets via endovascular devices commands several principles: dissolution, diffusion, convection, drug binding, barriers to absorption, and interaction between the drug, delivery vehicle, and accepting arterial wall. The understanding of drug delivery in the coronary vasculature is vast; there is ongoing work needed in the peripheral arteries. There are differences that account for some failures of application of coronary technology into the peripheral vascular space. Breakthroughs in peripheral vascular interventional techniques building on current technologies require investigators willing to acknowledge the similarities and differences between these different vascular territories, while developing technologies adapted for peripheral arteries.
Collapse
Affiliation(s)
- Jun Li
- Division of Cardiovascular Medicine, Department of Interventional Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Cleveland, OH 44106, USA; Department of Medicine, Case Western Reserve University School of Medicine, 2109 Adelbert Road, Cleveland, OH 44106, USA
| | | | - Sandeep M Patel
- Division of Cardiovascular Medicine, Department of Interventional Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Cleveland, OH 44106, USA; Department of Medicine, Case Western Reserve University School of Medicine, 2109 Adelbert Road, Cleveland, OH 44106, USA
| | - Sahil A Parikh
- Endovascular Services, Division of Cardiology, Department of Medicine, Center for Interventional Vascular Therapy, Columbia University Medical Center/NY Presbyterian Hospital, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, New York, NY 10032, USA.
| |
Collapse
|
18
|
Jujo K, Saito K, Ishida I, Kim A, Suzuki Y, Furuki Y, Ouchi T, Ishii Y, Sekiguchi H, Yamaguchi J, Ogawa H, Hagiwara N. Intimal disruption affects drug-eluting cobalt-chromium stent expansion: A randomized trial comparing scoring and conventional balloon predilation. Int J Cardiol 2016; 221:23-31. [DOI: 10.1016/j.ijcard.2016.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 07/01/2016] [Accepted: 07/02/2016] [Indexed: 10/21/2022]
|
19
|
Trant JF, Abd Rabo Moustafa MM, Sran I, Gillies ER. Polyisobutylene-paclitaxel conjugates with pendant carboxylic acids and polystyrene chains: Towards multifunctional stent coatings with slow drug release. JOURNAL OF POLYMER SCIENCE PART A: POLYMER CHEMISTRY 2016; 54:2209-2219. [DOI: 10.1002/pola.28094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- John F. Trant
- Department of Chemistry; The University of Western Ontario; 1151 Richmond St London Canada N6A 5B7
| | | | - Inderpreet Sran
- Department of Chemistry; The University of Western Ontario; 1151 Richmond St London Canada N6A 5B7
| | - Elizabeth R. Gillies
- Department of Chemistry; The University of Western Ontario; 1151 Richmond St London Canada N6A 5B7
- Department of Chemical and Biochemical Engineering; The University of Western Ontario; 1151 Richmond St London Canada N6A 5B9
| |
Collapse
|
20
|
Abstract
Implantation of drug-eluting stents (DESs) via percutaneous coronary intervention is the most popular treatment option to restore blood flow to occluded vasculature. The many devices currently used in clinic and under examination in research laboratories are manufactured using a variety of coating techniques to create the incorporated drug release platforms. These coating techniques offer various benefits including ease of use, expense of equipment, and design variability. This review paper discusses recent novel DES designs utilizing individual or a combination of these coating techniques and their resulting drug release profiles.
Collapse
Affiliation(s)
- Megan Livingston
- Department of Regenerative Medicine and Orthopaedics, Houston Methodist Research Institute, Houston, USA
| | - Aaron Tan
- Centre for Nanotechnology & Regenerative Medicine, UCL Division of Surgery & Interventional Science, UCL Medical School, University College London (UCL), London, UK
| |
Collapse
|
21
|
Trant JF, Sran I, de Bruyn JR, Ingratta M, Borecki A, Gillies ER. Synthesis and properties of arborescent polyisobutylene derivatives and a paclitaxel conjugate: Towards stent coatings with prolonged drug release. Eur Polym J 2015. [DOI: 10.1016/j.eurpolymj.2015.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
22
|
Trant JF, McEachran MJ, Sran I, Turowec BA, de Bruyn JR, Gillies ER. Covalent Polyisobutylene-Paclitaxel Conjugates for Controlled Release from Potential Vascular Stent Coatings. ACS APPLIED MATERIALS & INTERFACES 2015; 7:14506-14517. [PMID: 26066902 DOI: 10.1021/acsami.5b04001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The development of covalent polyisobutylene (PIB)-paclitaxel (PTX) conjugates as a potential approach to controlling drug release from vascular stent coatings is described. PIB-PTX materials containing ∼24 and ∼48 wt % PTX, conjugated via ester linkages, were prepared. The PTX release profiles were compared with those of physical mixtures of PTX with carboxylic acid-functionalized PIB and with the triblock copolymer polystyrene-b-PIB-b-polystyrene (SIBS). Covalent conjugation led to significantly slower drug release. Atomic force microscopy imaging of coatings of the materials suggested that the physical mixtures exhibited multiple domains corresponding to phase separation, whereas the materials in which PTX was covalently conjugated appeared homogeneous. Coatings of the conjugated materials on stainless steel surfaces suffered less surface erosion than the physically mixed materials, remained intact, and adhered well to the surface throughout the thirty-five day study. Tensile testing and rheological studies suggested that the incorporation of PTX into the polymer introduces similar physical changes to the PIB as the incorporation of a glassy polystyrene block does in SIBS. Cytotoxicity assays showed that the coatings did not release toxic levels of PTX or other species into a cell culture medium over a 24 h period, yet the levels of PTX in the materials were sufficient to prevent C2C12 cells from adhering to and proliferating on them. Overall, these results indicate that covalent PIB-PTX conjugates have promise as coatings for vascular stents.
Collapse
Affiliation(s)
- John F Trant
- †Department of Chemistry, University of Western Ontario, 1151 Richmond Street, London N6A 5B7, Canada
| | - Matthew J McEachran
- †Department of Chemistry, University of Western Ontario, 1151 Richmond Street, London N6A 5B7, Canada
| | - Inderpreet Sran
- ‡Department of Chemical and Biochemical Engineering, The University of Western Ontario, 1151 Richmond Sreet, London N6A 5B9, Canada
| | - Bethany A Turowec
- §Biomedical Engineering Graduate Program, The University of Western Ontario, 1151 Richmond Street, London N6A 5B9, Canada
| | - John R de Bruyn
- ∥Department of Physics and Astronomy, The University of Western Ontario, 1151 Richmond Street, London N6A 5B7, Canada
| | - Elizabeth R Gillies
- †Department of Chemistry, University of Western Ontario, 1151 Richmond Street, London N6A 5B7, Canada
- ‡Department of Chemical and Biochemical Engineering, The University of Western Ontario, 1151 Richmond Sreet, London N6A 5B9, Canada
| |
Collapse
|
23
|
Jacques A, Barthélémy B, Delhalle J, Mekhalif Z. 1-Pyrrolyl-10-decylammoniumphosphonate monolayer: a molecular nanolink between electropolymerized pyrrole films and nickel or titanium surfaces. Electrochim Acta 2015. [DOI: 10.1016/j.electacta.2015.04.123] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
24
|
Affiliation(s)
- Daniel S Kohane
- Laboratory for Biomaterials and Drug Delivery, Department of Anesthesiology, Division of Critical Care Medicine, Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA,
| | | |
Collapse
|
25
|
Damodaran VB, Bhatnagar D, Leszczak V, Popat KC. Titania nanostructures: a biomedical perspective. RSC Adv 2015. [DOI: 10.1039/c5ra04271b] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
A systematic and comprehensive summary of various TNS-based biomedical research with a special emphasis on drug-delivery, tissue engineering, biosensor, and anti-bacterial applications.
Collapse
Affiliation(s)
- Vinod B. Damodaran
- New Jersey Center for Biomaterials and Rutgers – The State University of New Jersey
- Piscataway
- USA
| | - Divya Bhatnagar
- New Jersey Center for Biomaterials and Rutgers – The State University of New Jersey
- Piscataway
- USA
| | - Victoria Leszczak
- Department of Mechanical Engineering and School of Biomedical Engineering
- Colorado State University
- Fort Collins
- USA
| | - Ketul C. Popat
- Department of Mechanical Engineering and School of Biomedical Engineering
- Colorado State University
- Fort Collins
- USA
| |
Collapse
|
26
|
Impact of coronary stent designs on acute stent recoil. J Cardiol 2014; 64:347-52. [DOI: 10.1016/j.jjcc.2014.02.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 01/31/2014] [Accepted: 02/08/2014] [Indexed: 11/18/2022]
|
27
|
Shirakabe A, Takano M, Yamamoto M, Kurihara O, Kobayashi N, Matsushita M, Tsurumi M, Okazaki H, Hata N, Shimizu W. Preventable effects of bare-metal stent on restenosis after everolimus-eluting stent deployment. Heart Vessels 2014; 31:434-7. [PMID: 25330762 DOI: 10.1007/s00380-014-0588-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 10/03/2014] [Indexed: 11/30/2022]
Abstract
This case report describes a patient who underwent implantation of a bare-metal stent (BMS) for the treatment of everolimus-eluting stent (EES) restenosis caused by chronic stent recoil, and the BMS successfully escaped from duplicate restenosis and target lesion revascularization (TLR).
Collapse
Affiliation(s)
- Akihiro Shirakabe
- Division of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan.
| | - Masamichi Takano
- Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan.
| | - Masanori Yamamoto
- Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Osamu Kurihara
- Division of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Nobuaki Kobayashi
- Division of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Masato Matsushita
- Division of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Masafumi Tsurumi
- Division of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Hirotake Okazaki
- Division of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Noritake Hata
- Division of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Wataru Shimizu
- Division of Cardiology, Nippon Medical School, Tokyo, Japan
| |
Collapse
|
28
|
Kumar P, Pillai R, Sreedharan M, Davidson D, Manjunath CN, Fischer L, Balakrishnan KP, D'Ascenzo F, Sheiban I. RAPSTROM™ first-in-man study long-term results of a biodegradable polymer sustained-release sirolimus-eluting stent in de novo coronary stenoses. J Interv Cardiol 2014; 27:373-80. [PMID: 25040871 DOI: 10.1111/joic.12132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Durable polymers used for first-generation drug-eluting stents (DES) potentially contribute to persistent inflammation and late DES thrombosis. We report the first real-life human experience with the rapamycin-eluting biodegradable polymer-coated Rapstrom stent. METHODS All consecutive patients with single de novo native coronary stenosis (<30 mm and between 2.5 and 4.0 mm) were enrolled. Major adverse cardiac events (MACE) at 1 year (cardiac death, myocardial infarction [Q and non-Q], or ischemia-driven target lesion revascularization) were the primary end-point. RESULTS A total of 123 patients were enrolled. The stent was implanted without complications in all patients, and no MACE were recorded at 30 days. At 12-month follow-up 9 patients (7.3%) experienced a MACE and 4 (3.2%) required a target lesion revascularization, while 1 (1%) stent thrombosis was recorded. A planned angiographic follow-up (FU) was performed in 73 patients (59%) at 9.4 ± 2.6 months following the index procedure. In-stent late loss was 0.16 ± 0.09 mm, and in-segment late loss was 0.18 ± 0.8 mm. CONCLUSION The Rapstrom biodegradable polymer rapamycin-eluting stent appeared safe and efficacious in this first real-life human experience, due to a low late lumen loss. Larger randomized studies are required to confirm these preliminary results.
Collapse
|
29
|
Nombela-Franco L, Ribeiro HB, Urena M, Pasian S, Allende R, Doyle D, DeLarochellière R, DeLarochellière H, Laflamme L, Laflamme J, Jerez-Valero M, Côté M, Pibarot P, Larose E, Dumont E, Rodés-Cabau J. Incidence, predictive factors and haemodynamic consequences of acute stent recoil following transcatheter aortic valve implantation with a balloon-expandable valve. EUROINTERVENTION 2014; 9:1398-406. [DOI: 10.4244/eijv9i12a237] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
30
|
|
31
|
Kandzari DE. Development and performance of the zotarolimus-eluting Endeavor®coronary stent. Expert Rev Med Devices 2014; 7:449-59. [DOI: 10.1586/erd.10.31] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
32
|
Abstract
Stent implantation in coronary stenosis has revolutionized the treatment of coronary artery disease. The introduction of antirestenotic drug coatings further improved their efficacy in reducing target vessel revascularizations. With increasing use of drug-eluting stents (DES), stent thrombosis (ST) rose as potentially fatal major complication. Initially, the incidence of ST late after stent implantation seemed to be similar for DES and bare metal stents until several studies proved otherwise in first-generation DES. Since then, the design and components of DES have been changed and new polymers, drugs and different combinations of platelet inhibitors have been introduced to further improve the safety of DES. In this review, the authors focus on the relationship between DES, lesion anatomy, implantation technique and pharmacology to avoid the occurrence of ST. Furthermore, the relationship between dual antiplatelet therapy, bleeding rate and its significant impact on patient outcome is discussed. Finally, some promising future concepts are highlighted.
Collapse
Affiliation(s)
- Florian N Riede
- Division of Cardiology, University Hospital, Basel, Switzerland
| | | | | |
Collapse
|
33
|
Dani S, Costa RA, Joshi H, Shah J, Pandya R, Virmani R, Sheiban I, Bhatt S, Abizaid A. First-in-human evaluation of the novel BioMime sirolimus-eluting coronary stent with bioabsorbable polymer for the treatment of single de novo lesions located in native coronary vessels - results from the meriT-1 trial. EUROINTERVENTION 2013; 9:493-500. [DOI: 10.4244/eijv9i4a79] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
34
|
Sun D, Zheng Y, Yin T, Tang C, Yu Q, Wang G. Coronary drug-eluting stents: From design optimization to newer strategies. J Biomed Mater Res A 2013; 102:1625-40. [DOI: 10.1002/jbm.a.34806] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 04/25/2013] [Accepted: 05/11/2013] [Indexed: 01/25/2023]
Affiliation(s)
- Daming Sun
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing Engineering Laboratory in Vascular Implants, Bioengineering College of Chongqing University; Chongqing 400044 People's Republic of China
| | - Yiming Zheng
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing Engineering Laboratory in Vascular Implants, Bioengineering College of Chongqing University; Chongqing 400044 People's Republic of China
| | - Tieying Yin
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing Engineering Laboratory in Vascular Implants, Bioengineering College of Chongqing University; Chongqing 400044 People's Republic of China
| | - Chaojun Tang
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing Engineering Laboratory in Vascular Implants, Bioengineering College of Chongqing University; Chongqing 400044 People's Republic of China
| | - Qingsong Yu
- Department of Mechanical and Aerospace Engineering; University of Missouri; Columbia Missouri 65211
| | - Guixue Wang
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing Engineering Laboratory in Vascular Implants, Bioengineering College of Chongqing University; Chongqing 400044 People's Republic of China
| |
Collapse
|
35
|
Characterization of tissue responses and degradation behavior of heparin-immobilized copolymer for drug-eluting stents. Polym Degrad Stab 2013. [DOI: 10.1016/j.polymdegradstab.2013.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
36
|
Anti-inflammatory effects of arsenic trioxide eluting stents in a porcine coronary model. BIOMED RESEARCH INTERNATIONAL 2013; 2013:937936. [PMID: 23509814 PMCID: PMC3581093 DOI: 10.1155/2013/937936] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 12/26/2012] [Indexed: 11/24/2022]
Abstract
Previous research from our group has demonstrated arsenic trioxide eluting stents significantly reduced neointimal area and thickness compared with bare metal stents. In the present study, the anti-inflammatory effects of arsenic trioxide in vitro and arsenic trioxide eluting stents in a porcine coronary model have been explored. Sixty-five pigs underwent placement of 139 oversized stents in the coronary arteries with histologic analysis, endothelial function analysis, and immunohistochemical and western blot analyses. Arsenic trioxide eluting stents effectively inhibited local inflammatory reactions, while no significant difference in endothelialization and endothelial function between arsenic trioxide eluting stents and bare metal stents was observed. Arsenic trioxide eluting stents favorably modulate neointimal formation due to less augmentation of early inflammatory reactions, and quick endothelialization of the stent surface, which might contribute to long-term safety and efficacy of drug eluting stents.
Collapse
|
37
|
Basalus MWZ, Tandjung K, Sen H, van Apeldoorn AA, Grijpma DW, von Birgelen C. Recent insights from scanning electron microscopic assessment of durable polymer-coated drug-eluting stents. Interv Cardiol 2012. [DOI: 10.2217/ica.12.67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
38
|
Puranik AS, Dawson ER, Peppas NA. Recent advances in drug eluting stents. Int J Pharm 2012; 441:665-79. [PMID: 23117022 DOI: 10.1016/j.ijpharm.2012.10.029] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 10/17/2012] [Accepted: 10/18/2012] [Indexed: 12/18/2022]
Abstract
One of the most common medical interventions to reopen an occluded vessel is the implantation of a coronary stent. While this method of treatment is effective initially, restenosis, or the re-narrowing of the artery frequently occurs largely due to neointimal hyperplasia of smooth muscle cells. Drug eluting stents were developed in order to provide local, site-specific, controlled release of drugs that can inhibit neointima formation. By implementing a controlled release delivery system it may be possible to control the time release of the pharmacological factors and thus be able to bypass some of the critical events associated with stent hyperplasia and prevent the need for subsequent intervention. However, since the advent of first-generation drug eluting stents, long-term adverse effects have raised concerns regarding their safety. These limitations in safety and efficacy have triggered considerable research in developing biodegradable stents and more potent drug delivery systems. In this review, we shed light on the current state-of-the-art in drug eluting stents, problems related to them and highlight some of the ongoing research in this area.
Collapse
Affiliation(s)
- Amey S Puranik
- Department of Chemical Engineering, The University of Texas at Austin, Austin, TX 78712, USA
| | | | | |
Collapse
|
39
|
Khan W, Farah S, Domb AJ. Drug eluting stents: Developments and current status. J Control Release 2012; 161:703-12. [PMID: 22366546 DOI: 10.1016/j.jconrel.2012.02.010] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 02/07/2012] [Accepted: 02/11/2012] [Indexed: 11/27/2022]
|
40
|
Rong HJ, Chen WL, Guo SR, Lei L, Shen YY. PCL films incorporated with paclitaxel/5-fluorouracil: Effects of formulation and spacial architecture on drug release. Int J Pharm 2012; 427:242-51. [DOI: 10.1016/j.ijpharm.2012.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 01/12/2012] [Accepted: 02/05/2012] [Indexed: 11/29/2022]
|
41
|
Kohli SK, Wong A, Khurana R. How should I treat a mural perforation due to acute stent fracture in a calcified proximal LAD? EUROINTERVENTION 2012; 7:1350-60. [PMID: 22433198 DOI: 10.4244/eijv7i11a212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
42
|
Gundert TJ, Marsden AL, Yang W, LaDisa JF. Optimization of Cardiovascular Stent Design Using Computational Fluid Dynamics. J Biomech Eng 2012; 134:011002. [PMID: 22482657 DOI: 10.1115/1.4005542] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Coronary stent design affects the spatial distribution of wall shear stress (WSS), which can influence the progression of endothelialization, neointimal hyperplasia, and restenosis. Previous computational fluid dynamics (CFD) studies have only examined a small number of possible geometries to identify stent designs that reduce alterations in near-wall hemodynamics. Based on a previously described framework for optimizing cardiovascular geometries, we developed a methodology that couples CFD and three-dimensional shape-optimization for use in stent design. The optimization procedure was fully-automated, such that solid model construction, anisotropic mesh generation, CFD simulation, and WSS quantification did not require user intervention. We applied the method to determine the optimal number of circumferentially repeating stent cells (NC) for slotted-tube stents with various diameters and intrastrut areas. Optimal stent designs were defined as those minimizing the area of low intrastrut time-averaged WSS. Interestingly, we determined that the optimal value of NC was dependent on the intrastrut angle with respect to the primary flow direction. Further investigation indicated that stent designs with an intrastrut angle of approximately 40 deg minimized the area of low time-averaged WSS regardless of vessel size or intrastrut area. Future application of this optimization method to commercially available stent designs may lead to stents with superior hemodynamic performance and the potential for improved clinical outcomes.
Collapse
Affiliation(s)
- Timothy J. Gundert
- Department of Biomedical Engineering,Marquette University,1515 West Wisconsin Avenue,Milwaukee, WI 53233
| | - Alison L. Marsden
- Mechanical and Aerospace Engineering Department,University of California San Diego,9500 Gillman Drive,La Jolla, CA 92093
| | - Weiguang Yang
- Mechanical and Aerospace Engineering Department,University of California San Diego,9500 Gillman Drive,La Jolla, CA 92093
| | - John F. LaDisa
- Department of Biomedical Engineering, Marquette University, 1515 West Wisconsin Avenue,Milwaukee, WI 53233; Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226; Department of Pediatrics,Division of Pediatrics,Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Wauwatosa, WI 53226
| |
Collapse
|
43
|
Xue L, Dai S, Li Z. Synthesis and characterization of elastic star shape-memory polymers as self-expandable drug-eluting stents. ACTA ACUST UNITED AC 2012. [DOI: 10.1039/c2jm15918j] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
44
|
Lei L, Liu X, Shen YY, Liu JY, Tang MF, Wang ZM, Guo SR, Cheng L. Zero-order release of 5-fluorouracil from PCL-based films featuring trilayered structures for stent application. Eur J Pharm Biopharm 2011; 78:49-57. [DOI: 10.1016/j.ejpb.2011.01.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 12/10/2010] [Accepted: 01/11/2011] [Indexed: 11/15/2022]
|
45
|
Novel Drug Eluting Stent Systems. Interv Cardiol 2011. [DOI: 10.1002/9781444319446.ch37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
46
|
Grudtner MA, de Lara Elesbão JL, Gutierrez PS, Meyer FS, Pereira AH. Histological analysis of cobalt-chromium stents with and without Camouflage® polymer coating: experimental porcine carotid artery model. Vascular 2011; 19:89-96. [PMID: 21489934 DOI: 10.1258/vasc.2010.oa0268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study evaluated the arterial response to cobalt-chromium stents with and without polymer coating (Camouflage®, Hemoteq AG, Wuerselen, Germany) implanted in pigs. Cobalt-chromium balloon-expandable stents (4 × 16 mm) were implanted in the common carotid arteries of nine pigs. Histological analysis of endothelialization, inflammation and injury was performed one month later. All stents were successfully deployed, and all but one animal survived the 30 study days. All arteries were patent. Endothelialization was nearly complete in most sections of all carotid stents in both groups. There were mild inflammatory infiltrate and mild-to-moderate injury, which were associated with the stent shafts and not significantly different between groups. Our findings suggest that, in porcine carotid arteries, the histological response to balloon-expandable cobalt-chromium stents coated with polymer (Camouflage®, Hemoteq AG) is similar to the response to non-coated cobalt-chromium stents.
Collapse
|
47
|
Wiemer M, Butz T, Schmidt W, Schmitz KP, Horstkotte D, Langer C. Scanning electron microscopic analysis of different drug eluting stents after failed implantation: from nearly undamaged to major damaged polymers. Catheter Cardiovasc Interv 2010; 75:905-11. [PMID: 20088011 DOI: 10.1002/ccd.22347] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Implantation of drug eluting stents (DES) in tortuous and/or calcified vessels is much more demanding compared with implantation of bare metal stents (BMS) due to their larger diameters. It is unknown whether drug eluting stent coatings get damaged while crossing these lesions. METHODS In 42 patients (34 male, 68.1 +/- 10 years) with 45 calcified lesions (15.9 mm +/- 7.9 mm), DES could not be implanted, even after predilatation. Diabetes was present in 19 patients (45%). Sixty-one stents were used; 19 Cypher select, 18 Taxus Liberté, 10 CoStar, 5 Endeavor RX, 4 Xience V. 3 Janus Carbostent, 1 Yukon Choice S, and 1 Axxion DES. The entire accessible surface area of these stents, in either the unexpanded and expanded state, were examined with an environmental scanning electron microscope (XL30 ESEM, Philips) to evaluate polymer or surface damage. RESULTS The polymers of Taxus Liberte, Cypher Select, Xience V, CoStar, and Janus DES were only slightly damaged (less than 3% of surface area), whereas the Endeavor RX Stents showed up to 20% damaged surface area. In DES without a polymer (Yukon and Axxion), it could be shown that most of the stent surface (up to 40%) were without any layer of drug. CONCLUSION Placement of drug eluting stents in tortuous vessels and/or calcified lesions could cause major surface damage by scratching and scraping of the polymer or drug by the arterial wall, even before implantation. There were remarkable differences among the stents examined, only minor damage with the Cypher, Taxus Costar, Janus, and Xience V, whereas the Endeavor, the Yukon, and the Janus DES showed large areas of surface injury.
Collapse
Affiliation(s)
- Marcus Wiemer
- Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
| | | | | | | | | | | |
Collapse
|
48
|
ADLAKHA SATJIT, SHEIKH MUJEEB, WU JASON, BURKET MARKW, PANDYA UTPAL, COLYER WILLIAM, ELTAHAWY EHAB, COOPER CHRISTOPHERJ. Stent Fracture in the Coronary and Peripheral Arteries. J Interv Cardiol 2010; 23:411-9. [DOI: 10.1111/j.1540-8183.2010.00567.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
49
|
Liu SJ, Chiang FJ, Hsiao CY, Kau YC, Liu KS. Fabrication of Balloon-Expandable Self-Lock Drug-Eluting Polycaprolactone Stents Using Micro-Injection Molding and Spray Coating Techniques. Ann Biomed Eng 2010; 38:3185-94. [DOI: 10.1007/s10439-010-0075-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 05/11/2010] [Indexed: 10/19/2022]
|
50
|
Basalus M, van Houwelingen K, Ankone M, Feijen J, von Birgelen C. Micro-computed tomographic assessment following extremely oversized partial postdilatation of drug-eluting stents. EUROINTERVENTION 2010. [DOI: 10.4244/eijv6i1a21] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|