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Biodegradable stents

Tobias Koppara, Tomohisa Tada, Erion Xhepa, Sebastian Kufner, Robert A Byrne, Tareq Ibrahim, Karl-Ludwig Laugwitz, Adnan Kastrati, Michael Joner
BACKGROUND: Drug-eluting stents with biodegradable polymer coatings have shown promising outcomes in randomised studies. METHODS: We compared neointimal healing patterns including strut coverage and assessed neointimal maturity using a novel algorithm in coronary lesions treated with sirolimus-eluting stents with biodegradable polymer coating (BP-SES) or everolimus eluting stents with permanent polymer coating (PP-EES) using optical coherence tomography after 6months...
May 1, 2018: International Journal of Cardiology
Liang Jin, Jing Wu, Guangyin Yuan, Tongxin Chen
Biodegradable Mg-based alloys have shown great potential as bone fixation devices or vascular stents. As implant biomaterials, the foreign body reaction (FBR) is an important issue to be studied, where the inflammatory cells play a key role. Here, we used two inflammatory cell lines i.e. THP-1 cells and THP-1 macrophages, to evaluate the effect of Mg-Nd-Zn-Zr alloy (denoted as JDBM) extracts on cell viability, death modes, cell cycle, phagocytosis, differentiation, migration and inflammatory response. The results showed that high-concentration extract induced necrosis and complete damage of cell function...
2018: PloS One
Bruce F Sabath, David E Ost
PURPOSE OF REVIEW: The current review describes the latest evidence regarding the use of stents for malignant airway obstruction. RECENT FINDINGS: Therapeutic bronchoscopy, including stenting, can restore patency in up to 93% of patients with malignant central airway obstruction. The patients that benefit the most are those with worse baseline dyspnea, higher American Society of Anesthesiology score, poorer functional status, and central obstruction (rather than lobar)...
March 13, 2018: Current Opinion in Pulmonary Medicine
Salvatore Cassese, Gjin Ndrepepa, Robert A Byrne, Sebastian Kufner, Anna Lena Lahmann, Nader Mankerious, Erion Xhepa, Karl-Ludwig Laugwitz, Heribert Schunkert, Massimiliano Fusaro, Adnan Kastrati, Michael Joner
AIMS: The ultrathin strut biodegradable-polymer sirolimus-eluting stent (SES) is a new-generation drug-eluting stent (DES) developed to improve the percutaneous treatment of patients with coronary artery disease. Here, we sought to investigate whether the performance of ultrathin strut biodegradable-polymer SES is superior to that of the benchmark thin-strut fluoropolymer-based everolimus-eluting stent (EES). METHODS AND RESULTS: We undertook a study-level meta-analysis of trials, in which patients receiving percutaneous coronary intervention (PCI) were randomly assigned to either SES or EES...
March 13, 2018: EuroIntervention
Ehsan Mostaed, Malgorzata Sikora-Jasinska, Jaroslaw W Drelich, Maurizio Vedani
The search for biodegradable metals with mechanical properties equal or higher to those of currently used permanent biomaterials, such as stainless steels, cobalt chromium and titanium alloys, desirable in vivo degradation rate and uniform corrosion is still an open challenge. Magnesium (Mg), iron (Fe) and zinc (Zn)-based alloys have been proposed as biodegradable metals for medical applications. Over the last two decades, extensive research has been done on Mg and Fe. Fe-based alloys show appropriate mechanical properties, but their degradation rate is an order of magnitude below the benchmark value...
March 9, 2018: Acta Biomaterialia
Hualan Jin, Shan Zhao, Roger Guillory, Patrick K Bowen, Zhiyong Yin, Adam Griebel, Jeremy Schaffer, Elisha J Earley, Jeremy Goldman, Jaroslaw W Drelich
It is still an open challenge to find a biodegradable metallic material exhibiting sufficient mechanical properties and degradation behavior to serve as an arterial stent. In this study, Zn-Mg alloys of 0.002 (Zn-002Mg), 0.005 (Zn-005Mg) and 0.08wt% Mg (Zn-08Mg) content were cast, extruded and drawn to 0.25mm diameter, and evaluated as potential biodegradable stent materials. Structural analysis confirmed formation of Mg2 Zn11 intermetallic in all three alloys with the average grain size decreasing with increasing Mg content...
March 1, 2018: Materials Science & Engineering. C, Materials for Biological Applications
Kai Xu, Yaling Han, Bo Xu, Yuejin Yang, Geng Wang, Hui Li, Yong Sun, Ling Tao, Haichang Wang, Zuyi Yuan, Liu Huiliang, Jinghua Liu, Yongping Jia, Genshan Ma, Guosheng Fu, Xiaodong Li, Shuren Li, Shouli Wang, Kui Pu
AIMS: We performed a multicenter, randomized controlled trial to determine the noninferiority of a novel biodegradable-polymer drug-eluting stent (BP-DES), the EXCEL 2 stent, to the first generation BP-DES, the EXCEL stent. METHODS AND RESULTS: Patients (n=419) scheduled to undergo percutaneous coronary intervention (PCI) were randomized to receive either the EXCEL 2 stent (n=208) or the EXCEL stent(n=211) from 15 Chinese centers. At 9 months, primary endpoint in-stent late loss (LL) difference was -0...
March 1, 2018: Cardiovascular Therapeutics
Pil Hyung Lee, Osung Kwon, Jung-Min Ahn, Cheol Hyun Lee, Do-Yoon Kang, Jung-Bok Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Limited data are available on the relative performances between different types of drug-eluting stents (DES) for obstructive left main coronary artery disease (LMCAD). OBJECTIVES: This study sought to compare effectiveness and safety profiles of various second-generation DES for LMCAD in real-world clinical practice. METHODS: Among 4,470 patients in 3, multicenter, prospective registries (IRIS-DES [Interventional Cardiology Research Incorporation Society-Drug-Eluting Stents] registry, the IRIS-MAIN [Interventional Cardiology Research Incorporation Society-Left MAIN Revascularization] registry, and the PRECOMBAT [PREmier of Randomized COMparison of Bypass Surgery versus AngioplasTy Using Drug-Eluting Stent in Patients with Left Main Coronary Artery Disease] study) treated between July 2007 and July 2015, the authors identified 2,692 patients with significant LMCAD who received second-generation DES; 1,254 with cobalt-chromium everolimus-eluting stents (CoCr-EES), 232 with biodegradable polymer biolimus-eluting stents (BP-BES), 616 with platinum-chromium EES (PtCr-EES), and 590 with Resolute zotarolimus-eluting stent (Re-ZES)...
February 27, 2018: Journal of the American College of Cardiology
Federico Soria, Esther Morcillo, Alvaro Serrano, Alberto Budia, Inmaculada Fernández, Tomás Fernández-Aparicio, Francisco M Sanchez-Margallo
OBJECTIVES: The purpose is to determine the effects in urinary tract of a new antireflux biodegradable ureteral stent. MATERIAL AND METHODS: Thirty six ureters belonging to 24 pigs were used. The study began with an endoscopic, nephrosonographic and fluoroscopic assessment. Three study groups of n=12 ureters were then specified. In Group I, a biodegradable antireflux stent (BDG-ARS) was inserted in the right ureter of 12 pigs. Group II was comprised by the left ureter of the same animals, in which a double pigtail stent was placed for 6 weeks...
February 19, 2018: Urology
Moritz Baquet, David Jochheim, Julinda Mehilli
Polymer-free drug-eluting stents (PF-DES) were designed with the expectation of avoiding late restenosis and thrombosis related to the polymer used in traditional DES platforms. Furthermore, due to similarities with bare metal stents after drug elution, PF-DES has been considered as particularly suitable for patients at high bleeding risk. A variety of PF-DES platforms have been clinically tested. Despite their theoretical advantages, PF platforms showed comparable clinical outcomes with modern permanent- or biodegradable polymer-based DES up to 5 years after implantation...
February 20, 2018: Journal of Interventional Cardiology
Clemens von Birgelen, Marlies M Kok, Naveed Sattar, Paolo Zocca, Cees Doelman, Gert D Kant, Marije M Löwik, Liefke C van der Heijden, Hanim Sen, K Gert van Houwelingen, Martin G Stoel, J Hans W Louwerenburg, Marc Hartmann, Frits H A F de Man, Gerard C M Linssen, Carine J M Doggen, Kenneth Tandjung
OBJECTIVES: This study sought to assess the prevalence and clinical impact of silent diabetes and pre-diabetes in "nondiabetic" percutaneous coronary intervention (PCI) all-comers. BACKGROUND: Patients with undetected and thus untreated (silent) diabetes may have higher event risks after PCI with contemporary drug-eluting stents (DES). METHODS: The BIO-RESORT Silent Diabetes study, performed at Thoraxcentrum Twente, is a substudy of the randomized multicenter BIO-RESORT (BIOdegradable Polymer and DuRable Polymer Drug-eluting Stents in an All COmeRs PopulaTion) trial (NCT01674803)...
February 8, 2018: JACC. Cardiovascular Interventions
Masahiro Natsuaki, Ken Kozuma, Takeshi Morimoto, Kazushige Kadota, Toshiya Muramatsu, Yoshihisa Nakagawa, Takashi Akasaka, Keiichi Igarashi Hanaoka, Kengo Tanabe, Yoshihiro Morino, Hideo Nishikawa, Takeshi Kimura
No abstract text is available yet for this article.
February 13, 2018: EuroIntervention
Brandon J Tefft, Susheil Uthamaraj, Adriana Harbuzariu, Jonathan Harburn, Tyra A Witt, Brant Newman, Peter J Psaltis, Ota Hlinomaz, David R Holmes, Rajiv Gulati, Robert D Simari, Dan Dragomir-Daescu, Gurpreet S Sandhu
Incomplete endothelialization of intracoronary stents has been associated with stent thrombosis and recurrent symptoms, whereas prolonged use of dual antiplatelet therapy increases bleeding related adverse events. Facilitated endothelialization has the potential to improve clinical outcomes in patients who are unable to tolerate dual antiplatelet therapy. The objective of this study is to demonstrate the feasibility of magnetic cell capture to rapidly endothelialize intracoronary stents in a large animal model...
February 12, 2018: Tissue Engineering. Part A
Juan F Iglesias, Thomas Pilgrim
No abstract text is available yet for this article.
January 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Myriam Delhaye, Jacques Devière
No abstract text is available yet for this article.
February 2018: Gastrointestinal Endoscopy
Juan Wang, Changdong Guan, Shubin Qiao, Xuebin Cao, Lei Qin, Yi Li, Zhanquan Li, Xueqi Li, Jiansong Yuan, Runlin Gao, Bo Xu
AIMS: In PANDA III trial, the novel poly-lactide-co-glycolide polymer-based BuMA sirolimus-eluting stent (SES) was non-inferior to the polylactide polymer-based Excel SES for the primary endpoint of 1-year target lesion failure (TLF), with a lower incidence of stent thrombosis. We sought to investigate whether the effectiveness profile of BuMA SES, with more rapid drug elution and polymer absorption kinetics, would persist at 2 years. METHODS AND RESULTS: A total of 2,348 patients (mean age, 61...
February 6, 2018: EuroIntervention
Pravesh Kumar Bundhun, Manish Pursun, Feng Huang
BACKGROUND: Even if drug-eluting stents (DES) showed beneficial effects in patients with coronary artery diseases (CADs), limitations have been observed with the first-generation durable polymer DES (DP-DES). Recently, biodegradable polymer DES (BP-DES) have been approved to be used as an alternative to DP-DES, with potential benefits. We aimed to systematically compare BP-DES with the first-generation DP-DES using a large number of randomized patients. METHODS: Electronic databases were searched for randomized controlled trials (RCTs) comparing BP-DES with first-generation DP-DES...
November 2017: Medicine (Baltimore)
Xiang-Ji Li, Lin Xie, Fu-Sheng Pan, Yong Wang, Hong Liu, Yu-Rong Tang, Cindy Ml Hutnik
Technological advances in glaucoma have challenged the traditional treatment paradigm. Historically incisional surgery has been used in cases of advanced disease and/or uncontrolled intraocular pressures resistant to medical or laser interventions. More recently, perhaps due to advancements in imaging, surgery has been suggested to be beneficial earlier in the treatment paradigm. Despite these trends, surgical manipulation of the tissues and unpredictability of wound healing continue to result in surgical failure...
2018: International Journal of Ophthalmology
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Dobrin Vassilev, Ramesh Daggubati, Thach Nguyen, Minh Trí Nhân Nguyễn, Nicolas Foin
OBJECTIVES: We assess the mid-term outcomes of ultrathin biodegradable polymer double stenting using a very minimal crushing (Nano-Crush) technique in large complex coronary bifurcation. BACKGROUND: Complex bifurcations have been suggested to be better approached by a planned double stent technique. METHODS: Two hundred and five consecutive patients (107 males and 98 females) referred for large complex coronary bifurcation percutaneous coronary interventions were enrolled...
January 25, 2018: Catheterization and Cardiovascular Interventions
Jason Nogic, Liam M McCormick, Rohin Francis, Nitesh Nerlekar, Catherine Jaworski, Nick E J West, Adam J Brown
The introduction of drug-eluting stents (DES) significantly reduced angiographic restenosis and the clinical need for revascularization following percutaneous coronary intervention. However, concerns remain regarding the long-term safety and efficacy of DES. The use of durable polymers for drug elution that have limited biocompatibility is thought to contribute toward DES failure, by promoting an adverse local inflammatory response and vascular toxicity. Biodegradable polymer and polymer-free metallic stents represent two novel technological solutions to this challenging clinical problem...
January 12, 2018: Journal of Cardiology
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