Key result
Microporous surfaces on coronary stents provide an effective polymer-free carrier for antiproliferative agents, demonstrating favorable clinical outcomes and accelerated endothelialization.
Why the study?
Late stent complications linked to prolonged indwelling of drug carrier polymers have prompted interest in polymer-free stent surface modifications, including micropores, for drug retention and distribution.
Microporous stent surfaces offer a promising polymer-free approach for drug delivery, potentially reducing late stent complications associated with polymer carriers.
Microporous polymer-free stents may reduce late complications; leaves open large RCTs before clinical adoption.
The introduction of coronary stents into clinical practice has reduced repeated patient visits compared with balloon angioplasty alone. Also, drug-eluting stents substantially reduced the restenosis incidence. Therefore, later complications related to the implantation of a stent coated with a cytostatic-containing polymer became more relevant. The mechanism of late stent complications is multifactorial. It is mainly due to the body's response to the prolonged indwelling of the drug carrier polymer on the coronary stent's surface. There is a trend towards the return of polymer-free drug coating technologies, which are implemented through certain modifications of stent surfaces for better drug retention and proper drug distribution. It is mainly achieved using drug depots in various reservoirs: grooves, nanoparticles in the matrix compound, micropores, through and blind micro reservoirs, etc. New promising technologies for crystallizing cytostatic drugs or depositing them in specially designed reservoirs show good preclinical and clinical results, comparable or even superior to approved coronary stents. Micropores as carriers for antiproliferative agents on the stent surface are a promising direction to rejecting the use of polymers in stents.
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Kamolov et al. (2022) conducted a review in Coronary heart disease. Microporous surface stents vs. Polymer-coated stents was evaluated. Microporous surfaces on coronary stents provide an effective polymer-free carrier for antiproliferative agents, demonstrating favorable clinical outcomes and accelerated endothelialization.
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