Biolimus-eluting stent with biodegradable polymer: one step forward in the fight against stent thrombosis vulnerability?

Drug-eluting stents (DES) were developed to cope with the major problem of bare-metal stents: in-stent neointimal hyperplasia, which resulted in a high rate of in-stent restenosis. DES indeed reduced target lesion revascularization rates, but another problem arose: the problem of (very late) stent thrombosis. These higher rates of stent thrombosis in DES are (at least partly) explained by hypersensitivity and inflammatory reactions of the endothelium to the polymer coating of DES. This polymer coating carries and gradually releases the drug. New devices with more biocompatible polymers, or even polymers which are fully biodegradable, were developed. Polylactic acid is such a fully biodegradable polymer and it is used in the biolimus-eluting stents of the BioMatrix™ family. Herein, the technology and the performance of these new biolimus-eluting stents is reviewed, with the most up-to-date information from clinical studies.