Advances in stent drug delivery: the future is in bioabsorbable stents.
This expert opinion review offers a perspective on the future developments in drug-eluting stent design. Initial efforts were focused on reduction of in-stent restenosis, which the drug-eluting stents addressed effectively. Current concerns are predominantly with regard to risk of stent thrombosis and delayed endothelialization. All three components of the stent have been modified to achieve the goal of endothelialization and vessel healing: drug, polymer and the platform. We review different approaches to reduce this risk from design of different drug combinations, through less traumatic metallic stent platforms, via biodegradable polymers and, finally, fully biodegradable stents. It seems at this time that fully biodegradable solutions to stenting hold the greatest promise, but larger long-term studies are needed to evaluate fully their safety and efficacy in 'all-comer' patient populations. At the time of this review, design of a safe drug-eluting stent still remains a challenge.
Wykrzykowska
Joanna J
JJ
Department of Interventional Cardiology, Thoraxcentrum, Erasmus MC, 's Gravendijkwal 230, Ba583, 3015CE Rotterdam, The Netherlands.
Onuma
Yoshinobu
Y
Serruys
Patrick W
PW
D020341:Absorbable Implants / Q000009:adverse effects / Q000639:trends; D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects / Q000737:chemistry; D003324:Coronary Artery Disease / Q000628:therapy; D003328:Coronary Thrombosis / Q000517:prevention & control; D003692:Delayed-Action Preparations; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000639:trends; D004730:Endothelium, Vascular / Q000254:growth & development; D006083:Graft Occlusion, Vascular / Q000517:prevention & control; D006801:Humans
D001672:Biocompatible Materials; D003692:Delayed-Action Preparations