title: Impact of stent strut design in metallic stents and biodegradable scaffolds.
abstract: Advances in the understanding of healing mechanisms after stent implantation have led to the recognition of stent strut thickness as an essential factor affecting re-endothelialization and overall long term vessel healing response after Percutaneous Coronary Interventions (PCI). Emergence of Drug-eluting stents (DESs) with anti-proliferative coating has contributed to reducing the incidence of restenosis and Target Lesion Revascularization (TVR), while progress and innovations in stent materials have in the meantime facilitated the design of newer platforms with more conformability and thinner struts, producing lesser injury and improving integration into the vessel wall. Recent advances in biodegradable metal and polymer materials now also allow for the design of fully biodegradable platforms, which are aimed at scaffolding the vessel only temporarily to prevent recoil and constrictive remodeling of the vessel during the initial period required, and are then progressively resorbed thereby avoiding the drawback of leaving an unnecessary implant permanently in the vessel. The aim of this article is to review recent evolution in stent material and stent strut design while understanding their impact on PCI outcomes. The article describes the different metallic alloys and biodegradable material properties and how these have impacted the evolution of stent strut thickness and ultimately outcomes in patients.
authors.affiliation: National Heart Centre Singapore, Singapore. Electronic address: nicolas.foin@nhcs.com.sg.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Foin
authors.affiliation: National Heart Centre Singapore, Singapore.
authors.forename: Renick D
authors.initials: RD
authors.lastname: Lee
authors.affiliation: Department of Mechanical Engineering, University College London, UK.
authors.forename: Ryo
authors.initials: R
authors.lastname: Torii
authors.affiliation: Klinikum der Friedrich-Schiller Universität, Jena, Germany.
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Guitierrez-Chico
authors.affiliation: Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK.
authors.forename: Alessio
authors.initials: A
authors.lastname: Mattesini
authors.affiliation: International Centre for Circulatory Health, NHLI, Imperial College London, London, UK.
authors.forename: Sukhjinder
authors.initials: S
authors.lastname: Nijjer
authors.affiliation: International Centre for Circulatory Health, NHLI, Imperial College London, London, UK.
authors.forename: Sayan
authors.initials: S
authors.lastname: Sen
authors.affiliation: International Centre for Circulatory Health, NHLI, Imperial College London, London, UK.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Petraco
authors.affiliation: International Centre for Circulatory Health, NHLI, Imperial College London, London, UK.
authors.forename: Justin E
authors.initials: JE
authors.lastname: Davies
authors.affiliation: Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: CV Path, Gaithersburg, MD, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Joner
authors.affiliation: CV Path, Gaithersburg, MD, USA.
authors.forename: Renu
authors.initials: R
authors.lastname: Virmani
authors.affiliation: National Heart Centre Singapore, Singapore.
authors.forename: Philip
authors.initials: P
authors.lastname: Wong
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects / Q000592:standards*; D000818:Animals; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000592:standards; D006801:Humans; D008670:Metals / Q000009:adverse effects / Q000592:standards*; D011474:Prosthesis Design / Q000379:methods / Q000592:standards*; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects / Q000592:standards*; D054457:Tissue Scaffolds / Q000009:adverse effects / Q000592:standards*
chemical_list: D008670:Metals
keywords: Bioabsorbable scaffolds; DES; Neointimal coverage; PCI; Re-endothelialization; Strut thickness