Key result
Fully biodegradable stents hold the greatest promise for addressing stent thrombosis and delayed endothelialization, though designing a safe drug-eluting stent remains a challenge.
Fully biodegradable stents represent a promising future direction for coronary stenting to address the risks of stent thrombosis and delayed endothelialization associated with current drug-eluting stents.
May guide future stent design away from permanent platforms; leaves open optimal biodegradable drug-elution strategies.
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.
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Wykrzykowska et al. (2009) conducted a review in In-stent restenosis and stent thrombosis. Bioabsorbable stents was evaluated. Fully biodegradable stents hold the greatest promise for addressing stent thrombosis and delayed endothelialization, though designing a safe drug-eluting stent remains a challenge.
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