Will absorbable metal stent technology change our practice?
Peripheral stents aim to support revascularization procedures of intravascular stenoses by mechanically preventing vessel recoil and counteracting pathophysiologic processes of luminal re-narrowing triggered by procedural injury of the vessel wall. Despite improvements in stenting techniques and concomitant medication, repeated intervention due to target lesion re-stenosis is necessary on a significant percentage of patients. The permanent presence of an artificial implant plays a prominent role in the discussion of mechanisms causing in-stent restenosis. Permanent metallic implants pose the risk of a continuous interaction between non-absorbable stent and surrounding tissue, leading to physical irritation, long-term endothelial dysfunction, or chronic inflammatory reactions. In addition, there is a risk of stent fracture due to external mechanical forces. To overcome these shortcomings, technology of stenting 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 in the long-term perspective. This removes a potential trigger for late restenosis.
Bosiers
M
M
Department of Vascular Surgery, AZ St-Blasius, Dendermonde, Belgium. marc.bosiers@telenet.be
Deloose
K
K
Verbist
J
J
Peeters
P
P
D020341:Absorbable Implants; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation* / Q000639:trends*; D020099:Coated Materials, Biocompatible; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008670:Metals; D011474:Prosthesis Design; D015607:Stents
D020099:Coated Materials, Biocompatible; D008670:Metals