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Bioabsorbable vascular stents

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 Schaefer, 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-centre study was performed in patients undergoing percutaneous coronary intervention with BVS from 2013 to 2014...
June 1, 2016: 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
Sripal Bangalore, Bora Toklu, Deepak L Bhatt
BACKGROUND: Bioresorbable vascular scaffolds (BVS) have been shown to be non-inferior to second generation drug eluting stents in recent clinical trials. However, the trials were not powered for individual endpoints and there is concern for increased device thrombosis with BVS. METHODS: We performed a systematic search for randomized clinical trials of BVS versus EES. Efficacy outcomes were target lesion revascularization (TLR) and target vessel revascularization (TVR)...
June 1, 2016: International Journal of Cardiology
Paolo Sganzerla, Emanuela Tavasci
The use of bioresorbable vascular scaffolds (BVS) has many important and potentially useful features, on both pathophysiological and clinical grounds, for the treatment of native coronary artery stenosis. These advantages are less well established when BVS are employed in saphenous vein graft disease. We here describe a peculiar behavior of a previously (6 months) implanted BVS in a degenerated saphenous vein graft during treatment of an in-stent restenosis in a patient suffering from unstable angina. This BVS particular performance seems to suggest that different pathophysiological and anatomical conditions may play a relevant role in affecting the results of transluminal vascular therapy...
March 2016: Giornale Italiano di Cardiologia
Rabin Chakraborty, Soumya Patra, Suvro Banerjee, Arindam Pande, Aftab Khan, Prakash Chandra Mandol, Debashish Ghosh, Swapan Kumar De, Sankha Subhro Das, Raja Nag
BACKGROUND: The safety and efficacy of everolimus eluting bioabsorbable vascular scaffold (BVS) in the management of "ST" segment elevation myocardial infarction (STEMI) are yet to be established. AIMS: To evaluate immediate and short term safety and efficacy of the everolimus-eluting ABSORB BVS compared with non BVS drug eluting stent (DES) in patients with STEMI. METHODS: From December 2013 to December 2014, 220 patients with STEMI were included in this study...
April 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Andrzej Ochała, Zbigniew Siudak, Jacek Legutko, Radosław Parma, Zbigniew Chmielak, Stanisław Bartuś, Sławomir Dobrzycki, Marek Grygier, Tomasz Moszura, Tomasz Pawłowski, Dariusz Dudek
INTRODUCTION: The Board of the Association of Cardiovascular Interventions of the Polish Cardiac Society (AISN PTK) publishes annual data from the National PCI Registry (ORPKI) operated by the Jagiellonian University Medical College in Krakow. AIM: For the first time the AISN PTK report is based on the new electronic database implemented in Poland on January 1(st), 2014. MATERIAL AND METHODS: In 2014, there were 155 invasive cardiology centers registered in the ORPKI database (an increase by 1 center in comparison to 2013) and 92% of them had 24/7 percutaneous (PCI) duty...
2015: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Andreas Rudolph, Michael Teske, Sabine Illner, Volker Kiefel, Katrin Sternberg, Niels Grabow, Andreas Wree, Marina Hovakimyan
PURPOSE: Drug-eluting stents (DES) based on permanent polymeric coating matrices have been introduced to overcome the in stent restenosis associated with bare metal stents (BMS). A further step was the development of DES with biodegradable polymeric coatings to address the risk of thrombosis associated with first-generation DES. In this study we evaluate the biocompatibility of biodegradable polymer materials for their potential use as coating matrices for DES or as materials for fully bioabsorbable vascular stents...
2015: PloS One
Masahiko Asami, Jiro Aoki, Patrick W Serruys, Alexandre Abizaid, Shigeru Saito, Yoshinobu Onuma, Takeshi Kimura, Charles A Simonton, Kengo Tanabe
Coronary computer tomographic angiography (CCTA) for screening intra-arterial vessel disease is gaining rapid clinical acceptance in recent years, but its use for such assessments in metal-stented vessel segments is very limited due to blooming artifacts introduced by the metal. However, vessel segments treated by the polymeric everolimus-eluting bioresorbable vascular scaffolds (Absorb) are readily monitored for intravascular disease over time with CCTA. The data on the accuracy of multi-detector computed tomography (MDCT) in patients treated with Absorb is still sparse...
April 2016: Cardiovascular Intervention and Therapeutics
Elisabetta Moscarella, Attilio Varricchio, Eugenio Stabile, Anna Franzone, Francesco Granata, Antonio Rapacciuolo, Gennaro Galasso, Claudia Capozzolo, Plinio Cirillo, Vittorio Monda, Ida Monterforte, Francesco Borgia, Orlando Piro, Giulio Bonzani, Bruno Trimarco, Giovanni Esposito
BACKGROUND/PURPOSE: Coronary in-stent restenosis (ISR) is a clinical problem for which a satisfactory solution has not been found yet. Bioabsorbable drug eluting vascular scaffolds (BVSs) provide transient vessel scaffolding combined with prolonged drug delivery capability. The aim of this study was to investigate the safety of BVS for the treatment of coronary ISR. METHODS/MATERIALS: Between January 2013 and June 2013, 27 patients (31 lesions), presenting with either stable or unstable angina due to coronary ISR, were enrolled in a single arm, prospective, open label registry...
October 2015: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Gian Battista Danzi, Marco Sesana, Mario Arieti, Giuliano Villa, Sergio Rutigliano, Alessandro Aprile, Annamaria Nicolino, Shahram Moshiri, Renato Valenti
OBJECTIVES: To evaluate the acute recoil of the ABSORB bioabsorbable vascular scaffold (BVS) and its relationship with procedural characteristics in a real world population. BACKGROUND: In vivo acute recoil of the BVS was evaluated in selected patients. METHODS: Acute recoil was studied with videodensitometry in a consecutive series of patients treated by means of a BVS, and the results were compared with those obtained in subjects receiving an everolimus-eluting stent (EES)...
November 15, 2015: Catheterization and Cardiovascular Interventions
Jan-Marten Seitz, Martin Durisin, Jeremy Goldman, Jaroslaw W Drelich
Sutures that biodegrade and dissolve over a period of several weeks are in great demand to stitch wounds and surgical incisions. These new materials are receiving increased acceptance across surgical procedures whenever permanent sutures and long-term care are not needed. Unfortunately, both inflammatory responses and adverse local tissue reactions in the close-to-stitching environment are often reported for biodegradable polymeric sutures currently used by the medical community. While bioabsorbable metals are predominantly investigated and tested for vascular stent or osteosynthesis applications, they also appear to possess adequate bio-compatibility, mechanical properties, and corrosion stability to replace biodegradable polymeric sutures...
September 16, 2015: Advanced Healthcare Materials
Tobias Koppara, Qi Cheng, Kazuyuki Yahagi, Hiroyoshi Mori, Oscar David Sanchez, Julia Feygin, Eric Wittchow, Frank D Kolodgie, Renu Virmani, Michael Joner
BACKGROUND: Acute thrombogenicity and re-endothelialization represent clinically relevant end points pertaining to the safety of coronary stents, which have not been compared among biodegradable polymer-based drug-eluting metallic stents and fully bioabsorbable scaffolds to date. METHODS AND RESULTS: We investigated comparative outcomes with respect to acute thrombogenicity and re-endothelialization among thin-strut biodegradable polymer metallic everolimus eluting stents (EES), thick-strut fully bioabsorbable EES, thick-strut biodegradable polymer metallic biolimus-eluting stents and control bare metal stents...
June 2015: Circulation. Cardiovascular Interventions
Alessio La Manna, Andrea Mangiameli, Davide Capodanno, Giovanni Longo, Carmelo Sgroi, Corrado Tamburino
A 50-year-old man underwent coronary angiography for stable angina with evidence of chronic total occlusion of the right coronary artery. Chronic total occlusion recanalization was performed with implantation of 4 overlapping bioresorbable vascular scaffolds. At 12 months, elective follow-up coronary angiography documented an asymptomatic 90% in-scaffold restenosis of the right coronary artery located in the mid portion of a newly late-acquired aneurysm. To address the challenging issue introduced by the varying reference vessel diameters, a self-expandable stent was implanted...
May 2015: Canadian Journal of Cardiology
Wai-Ki Yiu, Michael S Conte
Endovascular treatment of femoropopliteal occlusive disease is challenging and often limited by its unique anatomic, hemodynamic and biomechanical constraints. Despite technical improvement, percutaneous transluminal angioplasty alone is not adequate to provide satisfactory long-term patency. Several randomized controlled trials have shown that primary nitinol stenting can provide a better short-term radiological patency in intermediate lesion, but the results were often limited by intrinsic stent complications, particularly in-stent restenosis...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
M El-Mourad, P Merveille, N Preumont
Since Gruentizg's first percutaneous transluminal ballon angioplasty in 1977 in Zurich, percuta. neous coronary intervention evolved significantly in order to overcome the numerous associated complications of each technique. Bare-metal stents (BMS) made their initial appearance followed by three generations of drug-eluting stents (DES). The use of bioabsorbable vascular scaffold stents (BVS) has become more frequent creating a temporary scaffold allowing healing of the endothelium within 2 years. In this article, we discuss the nomenclature of the main intravascular complications linked to percuta...
September 2014: Revue Médicale de Bruxelles
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