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Bioabsorbable vascular stents

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
Diego A Arroyo, Sara Schukraft, Zacharenia Kallinikou, Jean-Christophe Stauffer, Gérard Baeriswyl, Jean-Jacques Goy, Mario Togni, Stéphane Cook, Serban Puricel
Aims: To compare endothelium-dependent vasomotor function and vascular healing 15 months after implantation of two new-generation drug-eluting stents and biovascular scaffolds (BVS). Methods and results: A total of 28 patients previously treated with a SYNERGY stent (bioabsorbable polymer everolimus-eluting stents (BP-EES)), a PROMUS stent (persistent polymer everolimus-eluting stents (PP-EES)) or an ABSORB (BVS) underwent control coronary angiography, 15 months after implantation, coupled with optical coherence tomography imaging and supine bicycle exercise...
2018: Open Heart
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
Colin Wallis, Clare A McLaren
Tracheobronchomalacia is a rare but clinically troublesome condition in paediatrics. The softening of the major airways - which can include some or all of the tracheobronchial tree can lead to symptoms ranging from the minor (harsh barking cough, recurrent chest infections) to severe respiratory difficulties including prolonged ventilator support and 'near death attacks'. The causes are broadly divided into intrinsic softening of the airway wall which is considered a primary defect (e.g. syndromes; post tracheo-oesophageal fistula repair; extreme prematurity) or secondary malacia due to external compression from vascular structures or cardiac components...
October 13, 2017: Paediatric Respiratory Reviews
Yoshinobu Onuma, Maik J Grundeken, Shimpei Nakatani, Taku Asano, Yohei Sotomi, Nicolas Foin, Jaryl Ng, Takayuki Okamura, Joanna J Wykrzykowska, Robbert J de Winter, Robert-Jan van Geuns, Jacques Koolen, Evald Christiansen, Robert Whitbourn, Dougal McClean, Pieter Smits, Stephan Windecker, John A Ormiston, Patrick W Serruys
BACKGROUND: The long-term fate of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA) struts jailing side branch ostia has not been clarified. We therefore evaluate serially (post-procedure and at 6 months, 1, 2, 3, and 5 years) the appearance and fate of jailed Absorb bioresorbable vascular scaffold struts. METHODS AND RESULTS: We performed 3-dimensional optical coherence tomographic analysis of the ABSORB Cohort B trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions) up to 5 years using a novel, validated cut-plane analysis method...
September 2017: Circulation. Cardiovascular Interventions
Ron Waksman, Michael J Lipinski, Eduardo Acampado, Qi Cheng, Lila Adams, Sho Torii, Jiaxiang Gai, Rebecca Torguson, David M Hellinga, Peter C Westman, Michael Joner, Philine Zumstein, Frank D Kolodgie, Renu Virmani
BACKGROUND: A comparison in acute thrombogenicity between the Magmaris sirolimus-eluting bioabsorbable magnesium scaffold and the Absorb bioresorbable vascular scaffold has not been performed. This study assessed acute thrombogenicity of Magmaris compared with Absorb and the Orsiro hybrid drug-eluting stent in a porcine arteriovenous shunt model. METHODS AND RESULTS: An ex vivo porcine carotid jugular arteriovenous shunt was established and connected to SYLGARD tubing containing the Magmaris, Absorb, and Orsiro scaffolds/stents and allowed to run in the shunt for a maximum of 1 hour...
August 2017: Circulation. Cardiovascular Interventions
Diego Arroyo, Gregoire Gendre, Sara Schukraft, Zacharenia Kallinikou, Olivier Müller, Gérard Baeriswyl, Jean-Christophe Stauffer, Jean-Jacques Goy, Mario Togni, Stéphane Cook, Serban Puricel
BACKGROUND: Data from randomized controlled trials have shown that the ABSORB BVS is non-inferior to Cobalt Chromium everolimus-eluting stents at 2years. METHODS & RESULTS: The EVERBIO II trial (Comparison of Everolimus- and Biolimus-Eluting Coronary Stents with Everolimus-Eluting Bioresorbable Vascular Scaffold) is a single-center, assessor-blind, randomized controlled trial enrolling 240 patients with an allocation ration of 1:1:1 conducted at University and Hospital Fribourg, Switzerland...
September 15, 2017: International Journal of Cardiology
Gianluca Rigatelli, Marco Zuin, Jacopo Frigato, Fabio Dell'Avvocata, Federico Ronco, Alberto Mazza, Laura Oliva, Dario Adami, Emiliano Bedendo, Panin Stefano
BACKGROUND/PURPOSE: Bioabsorbable vascular scaffolds (BVS) are made from a radiolucent material. Their multiple implantations on a single long diffused segment requires a specific technique with imaging magnification, which could cause an increase in dose delivered during percutaneous coronary intervention (PCI) procedure. We aimed to identify differences in radiation dose, fluoroscopy and procedural times in Hybrid DES+ multiple BVS (Absorb, Abbott Inc., USA) implantation (hybrid metal/scaffold jacket) versus multiple III generation Drug-eluting stents (DES) (full-metal jacket) in patients with long and diffuse coronary artery disease of the left anterior descending (LAD) coronary artery...
May 18, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Sergio Berti, Ferdinando Varbella, Alfredo Marchese, Luigi Emilio Pastormerlo, Giuseppe Musumeci
The aim of this report is to analyse trends in Italian cathlab activity between 2010 and 2015. Data were obtained from the national database of the Italian Society of Interventional Cardiology (GISE), which includes 97% of Italian cardiac catheterisation laboratories. The number of percutaneous coronary interventions (PCI) has remained relatively stable in the past five years. We have observed a significant increase in the number of primary PCI (pPCI) from 471.5 to 557.5 per million inhabitants with a consequent reduction of rescue primary PCI/fibrinolysis...
May 15, 2017: EuroIntervention
Miguel E Lemmert, Keith Oldroyd, Paul Barragan, Maciej Lesiak, Robert A Byrne, Evgeny Merkulov, Joost Daemen, Yoshinobu Onuma, Karen Witberg, Robert-Jan van Geuns
BACKGROUND: Continuous improvements in stent technology make percutaneous coronary intervention (PCI) a potential alternative to surgery in selected patients with unprotected left main coronary artery (uLMCA) disease. The optimal duration of dual antiplatelet therapy (DAPT) in these patients remains undetermined, and in addition, new stent designs using a bioabsorbable polymer might allow shorter duration of DAPT. STUDY DESIGN: IDEAL-LM is a prospective, randomized, multicenter study that will enroll 818 patients undergoing uLMCA PCI...
May 2017: American Heart Journal
Payam Dehghani
Percutaneous coronary interventions will never become obsolete, as evolution is inherent to interventional cardiology. Current drug-eluting platforms have appreciably improved their safety and efficacy profiles in different clinical settings compared to first-generation devices such that it is difficult to consider other alternatives. However, there is definite biological plausibility to consider devices with bioabsorbable polymers and/or scaffolds. It is also an undeniable fact that many patients, based on variety of belief systems, would prefer not to have a permanently implanted device...
February 2017: Current Treatment Options in Cardiovascular Medicine
Wan Azman Wan Ahmad, Takaharu Nakayoshi, Ahmad Syadi Mahmood Zuhdi, Muhammad Dzafir Ismail, Yoshihiro Fukumoto, Takafumi Ueno
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
Boris Vesga, Hector Hernandez, Miguel Moncada, Pawel Gasior, Sergio Higuera, Antonio Dager, Camilo Arana, Juan A Delgado, Philippe Généreux, Akiko Maehara, Juan F Granada
AIMS: Bioresorbable polymer drug-eluting stent technologies have been considered to have the potential to enhance vascular healing by reducing polymer exposure to the vessel wall, potentially allowing the earlier discontinuation of dual antiplatelet therapy. At present, the early vascular healing response to this type of technologies is still unclear. PATIENTS AND METHODS: The TIMELESS study is a multicenter, prospective, single-arm study that enrolled real-world patients undergoing percutaneous coronary intervention...
March 2017: Coronary Artery Disease
Jing Liu, Bo Zheng, Pei Wang, Xingang Wang, Bin Zhang, Qiuping Shi, Tingfei Xi, Ming Chen, Shaokang Guan
Bioabsorbable magnesium alloys are becoming prominent as temporary functional implants, as they avoid the risks generated by permanent metallic implants such as persistent inflammation and late restenosis. Nevertheless, the overfast corrosion of Mg alloys under physiological conditions hinders their wider application as medical implant materials. Here we investigate a simple one-step process to introduce a cross-linked 3-amino-propyltrimethoxysilane (APTES) silane physical barrier layer on the surface of Mg-Zn-Y-Nd alloys prior to electrostatic spraying with rapamycin-eluting poly(lactic-co-glycolic acid) (PLGA) layer...
July 20, 2016: ACS Applied Materials & Interfaces
Gaoke Feng, Jianmin Xiao, Yuying Bi, Zhiyuan Lan, Xiaoxin Zheng, Zhao Lu, Jun Li, Kan Wu, Edward Kislauskis, Stephen McCarthy, Qiang Hu, Xuejun Jiang, Tim Wu, Roger Laham
Our previous studies have confirmed the superior biocompatibility of the poly-L-lactic acid/amorphous calcium phosphate (PLLA/ACP) scaffolds (PowerScaffold) compared to PLLA scaffolds and their similar 6-month radial strength compared with TAXUS stents. In order to conduct further dynamic observations on the performance of the PowerScaffold after 12-month implantation compared with the TAXUS stents. Twenty PowerScaffold and 20 TAXUS were implanted in porcine coronary arteries. At 12-month follow-up, Quantitative Coronary Angiography showed that the stent reference vessel diameter (3...
April 2016: Journal of Biomedical Nanotechnology
Diego Arroyo, Stéphane Cook, Serban Puricel
The fully bioabsorbable vascular scaffold (BVS) has been developed to reduce late adverse events after coronary stenting such as device thrombosis. The device consists of polylactic acid, which is gradually absorbed within the first few years after its implantation. The initial experience with the device in low-risk patients presenting with simple lesions was satisfying and generated optimism among interventional cardiologists by promising better patient outcomes. However, the unrestricted use of the device in patients presenting with a higher baseline risk and more complex lesions came at the cost of alarmingly high rates of early device thrombosis...
June 2016: Journal of Thoracic Disease
Benedikt Schrage, Moritz Seiffert, Kai Müllerleile, Elvin Zengin, Edith Lubos, Christoph Sinning, Ulrich Schäfer, Karsten Sydow, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Bioabsorbable vascular scaffolds (BVS) are a novel option for the treatment of coronary lesions in patients with stable coronary artery disease or acute coronary syndromes. We aimed to identify the influence of BVS implantation on radiation exposure and procedural outcomes compared to drug-eluting stents (DES) in daily clinical practice. METHODS: A retrospective single-center study was performed in patients undergoing percutaneous coronary intervention with BVS from 2013 to 2014...
February 2017: Minerva Cardioangiologica
Jun Ma, Nan Zhao, Donghui Zhu
Bioabsorbable metal zinc (Zn) is a promising new generation of implantable scaffold for cardiovascular and orthopedic applications. In cardiovascular stent applications, zinc ion (Zn(2+)) will be gradually released into the surrounding vascular tissues from such Zn-containing scaffolds after implantation. However, the interactions between vascular cells and Zn(2+) are still largely unknown. We explored the short-term effects of extracellular Zn(2+) on human smooth muscle cells (SMCs) up to 24 h, and an interesting biphasic effect of Zn(2+) was observed...
2016: Scientific Reports
James B McCLAIN, Wenda C Carlyle, Dennis J Donohoe, John A Ormiston
Drug-eluting stents (DES) have dramatically improved the long-term efficacy of percutaneous coronary intervention (PCI). Over the last decade there have been numerous advances in DES platforms, however, all but one currently approved DES in the United States and many of the approved DES worldwide still have 3 common features: a metal stent platform, an anti-proliferative drug, and a permanent polymer. In this context, the polymer is critical to control drug release, but the polymer serves no purpose after the drug is eluted...
October 2016: Minerva Cardioangiologica
Patrick K Bowen, Emily R Shearier, Shan Zhao, Roger J Guillory, Feng Zhao, Jeremy Goldman, Jaroslaw W Drelich
Metallic stents are used to promote revascularization and maintain patency of plaqued or damaged arteries following balloon angioplasty. To mitigate the long-term side effects associated with corrosion-resistant stents (i.e., chronic inflammation and late stage thrombosis), a new generation of so-called "bioabsorbable" stents is currently being developed. The bioabsorbable coronary stents will corrode and be absorbed by the artery after completing their task as vascular scaffolding. Research spanning the last two decades has focused on biodegradable polymeric, iron-based, and magnesium-based stent materials...
May 2016: Advanced Healthcare Materials
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