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From bare metal to barely anything: an update on coronary stenting
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From bare metal to barely anything: an update on coronary stenting
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Journal Article
From bare metal to barely anything: an update on coronary stenting
2018
Overview
Experimental data from a model of ex vivo flow loops showed that thick-strut stents are 1.5-fold more thrombogenic than otherwise identical thin-strut stents and are associated with more fibrin deposition and thrombus formation early after implantation in porcine coronary arteries. 10 As likely mechanism, strut thickness may modulate local blood flow with stagnation and recirculation occurring more likely in the vicinity of thick-struts as compared with thin-struts. [...]potential advantages of coronary stents featuring thinner struts are related to procedural aspects (increased flexibility, reduced stent profile, improved deliverability) and to a faster and more complete endothelial coverage after stent implantation. Polymer degradation is a complex process that requires a variable period of time between 3 to more than 12 months according to the type and composition of BP-DES ( figure 2 ). [...]the completion of drug release does not necessarily correspond to the elimination of the polymer coating from stent surface. About 50% of adverse events following PCI are indeed attributable to stent-related events rather than a progression of the underlying disease. 57 Moreover, patients with multivessel coronary artery disease, diabetes or diffuse disease remain challenging to treat with PCI in view of a relatively high rate of adverse cardiac events. [...]bioresorbable scaffolds remain a valid concept in the future. First-in-human evaluation of a novel polymer-free drug-filled stent: angiographic, IVUS, OCT, and clinical outcomes from the RevElution study.
Publisher
BMJ Publishing Group LTD
