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Biodegradable Polymers and Stents: the Next Generation?

  • Guilly Rebagay
  • Sripal BangaloreEmail author
Secondary Prevention and Intervention (D. Steinberg, Section Editor)
  • 11 Downloads
Part of the following topical collections:
  1. Topical Collection on Secondary Prevention and Intervention

Abstract

Purpose of Review

Stent design continues to evolve with newer generation of stents aimed at improving clinical outcomes. This review compares different generations of stents with a focus on biodegradable polymers and stents and their potential benefits.

Recent Findings

Drug-eluting stents (DES) reduce stent thrombosis when compared with bare-metal stents (BMS). However, they are associated with impaired vascular healing/endothelialization and excess very long-term events (beyond 1 year). Much of these events (beyond 1 year) have been attributed to continued inflammation due to the polymer. Biodegradable-polymer drug-eluting stents (BP DES) were designed to overcome this polymer related limitation of first-generation DP DES by combining the benefits of reduced in-stent restenosis seen with DES and the benefits of reduced very-late stent thrombosis and myocardial infarction due to absence of polymer with bare-metal stents (BMS). Earlier generation of BP DES showed superiority over first-generation DP DES but at best non-inferior to second-generation DP DES for clinical outcomes; however, the newer-generation BP DES with ultrathin struts show promise in further reducing clinical outcomes when compared with second-generation DP DES. Whether this is due to the biodegradable polymer or the ultrathin struts continues to be debated.

Summary

Biodegradable polymer stents in conjunction with ultrathin struts have shown promise as the next generation of DES; however, additional studies and long-term follow-up are needed to confirm these effects.

Keywords

Biodegradable polymer stent Ultrathin struts Restenosis 

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. Rebagay: None; Dr. Bangalore: Advisory board/Honoraria: Abbott Vascular, Biotronix, Amgen, Pfizer, AstraZeneca, Menarini, Reata; Research grants: Abbott Vascular, NHLBI.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.

References

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.New York University School of MedicineNew YorkUSA
  2. 2.Complex Coronary Intervention (Bellevue), Cardiac Catheterization Laboratory, Cardiovascular Outcomes Group, The Leon H. Charney Division of CardiologyNew York University School of MedicineNew YorkUSA

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