1
|
Beshchasna N, Saqib M, Kraskiewicz H, Wasyluk Ł, Kuzmin O, Duta OC, Ficai D, Ghizdavet Z, Marin A, Ficai A, Sun Z, Pichugin VF, Opitz J, Andronescu E. Recent Advances in Manufacturing Innovative Stents. Pharmaceutics 2020; 12:E349. [PMID: 32294908 PMCID: PMC7238261 DOI: 10.3390/pharmaceutics12040349] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases are the most distributed cause of death worldwide. Stenting of arteries as a percutaneous transluminal angioplasty procedure became a promising minimally invasive therapy based on re-opening narrowed arteries by stent insertion. In order to improve and optimize this method, many research groups are focusing on designing new or improving existent stents. Since the beginning of the stent development in 1986, starting with bare-metal stents (BMS), these devices have been continuously enhanced by applying new materials, developing stent coatings based on inorganic and organic compounds including drugs, nanoparticles or biological components such as genes and cells, as well as adapting stent designs with different fabrication technologies. Drug eluting stents (DES) have been developed to overcome the main shortcomings of BMS or coated stents. Coatings are mainly applied to control biocompatibility, degradation rate, protein adsorption, and allow adequate endothelialization in order to ensure better clinical outcome of BMS, reducing restenosis and thrombosis. As coating materials (i) organic polymers: polyurethanes, poly(ε-caprolactone), styrene-b-isobutylene-b-styrene, polyhydroxybutyrates, poly(lactide-co-glycolide), and phosphoryl choline; (ii) biological components: vascular endothelial growth factor (VEGF) and anti-CD34 antibody and (iii) inorganic coatings: noble metals, wide class of oxides, nitrides, silicide and carbide, hydroxyapatite, diamond-like carbon, and others are used. DES were developed to reduce the tissue hyperplasia and in-stent restenosis utilizing antiproliferative substances like paclitaxel, limus (siro-, zotaro-, evero-, bio-, amphi-, tacro-limus), ABT-578, tyrphostin AGL-2043, genes, etc. The innovative solutions aim at overcoming the main limitations of the stent technology, such as in-stent restenosis and stent thrombosis, while maintaining the prime requirements on biocompatibility, biodegradability, and mechanical behavior. This paper provides an overview of the existing stent types, their functionality, materials, and manufacturing conditions demonstrating the still huge potential for the development of promising stent solutions.
Collapse
Affiliation(s)
- Natalia Beshchasna
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, Maria-Reiche-Str. 2, 01109 Dresden, Germany; (M.S.); (J.O.)
| | - Muhammad Saqib
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, Maria-Reiche-Str. 2, 01109 Dresden, Germany; (M.S.); (J.O.)
| | | | - Łukasz Wasyluk
- Balton Sp. z o.o. Modlińska 294, 03-152 Warsaw, Poland; (H.K.); (Ł.W.)
| | - Oleg Kuzmin
- VIP Technologies, Prospect Academicheskiy 8/2, 634055 Tomsk, Russia;
| | - Oana Cristina Duta
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
| | - Denisa Ficai
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
| | - Zeno Ghizdavet
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
| | - Alexandru Marin
- Department of Hydraulics, Hydraulic Machinery and Environmental Engineering, Faculty of Power Engineering, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania;
| | - Anton Ficai
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
- Academy of Romanian Scientists, Spl. Independentei 54, 050094 Bucharest, Romania
| | - Zhilei Sun
- Research School of High-Energy Physics, Tomsk Polytechnic University, Lenin Avenue 30, 634050 Tomsk, Russia;
| | - Vladimir F. Pichugin
- Research School of High-Energy Physics, Tomsk Polytechnic University, Lenin Avenue 30, 634050 Tomsk, Russia;
| | - Joerg Opitz
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, Maria-Reiche-Str. 2, 01109 Dresden, Germany; (M.S.); (J.O.)
| | - Ecaterina Andronescu
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
- Academy of Romanian Scientists, Spl. Independentei 54, 050094 Bucharest, Romania
| |
Collapse
|
2
|
Megaly M, Saad M, Brilakis ES. Role of Drug-coated Balloons in Small-vessel Coronary Artery Disease. US CARDIOLOGY REVIEW 2019. [DOI: 10.15420/usc.2019.4.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Percutaneous coronary intervention of small-vessel coronary artery disease (SVD) remains challenging due to difficulties with device delivery and high restenosis rate, even with the use of newer-generation drug-eluting stents. Drug-coated balloons represent an attractive emerging percutaneous coronary intervention option in patients with SVD. Potential advantages of drug-coated balloons in SVD include enhanced deliverability because of their small profile, avoidance of foreign-body implantation, and shorter duration of dual antiplatelet therapy.
Collapse
Affiliation(s)
- Michael Megaly
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN; Division of Cardiovascular Medicine, Hennepin Healthcare, Minneapolis, MN
| | - Marwan Saad
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas, Little Rock, AR; Department of Cardiovascular Medicine, Ain Shams University, Cairo, Egypt
| | | |
Collapse
|