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Raj B, Pg P, Sapa H, Shaji SS, T S, Kp AU, K K, Varma P. Small-Diameter Stents in Cardiovascular Applications. Chem Biodivers 2025:e202402008. [PMID: 39901606 DOI: 10.1002/cbdv.202402008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Revised: 02/01/2025] [Accepted: 02/03/2025] [Indexed: 02/05/2025]
Abstract
Small-diameter stents play a crucial role in treating congenital heart diseases and variety of vascular conditions that have application from paediatrics to geriatric conditions, and a comprehensive review in this direction is lacking. This review explores historical development, design innovations, material compositions and mechanistic insights into functions of small-diameter stents, with a specific emphasis on biodegradable options. The necessity for stents that can adapt to growth of paediatric patients is discussed, highlighting the transition from durable polymers to bioresorbable materials such as polylactic acid (PLA) and magnesium alloys. While acknowledging the advancements made in reducing complications like restenosis and thrombosis, the review addresses the challenges that persist, including the need for improved biocompatibility and minimization of late adverse cardiac events associated with certain stent technologies. A detailed examination of various stent generations emphasizes the importance of drug release kinetics, structural integrity and potential for personalized interventions based on patient-specific factors. The exploration of novel therapeutic compounds, including nanoparticles and interfering RNA, illustrates the ongoing research aimed at enhancing stent efficacy. Ultimately, the review seeks to provide a comprehensive understanding of current landscape while identifying the gaps that future research must address to develop the ideal stent for diverse patient populations.
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Affiliation(s)
- Bhavana Raj
- Department of Pharmaceutics, Amrita School of Pharmacy, Amrita Institute of Medical Sciences and Research Centre, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Prajitha Pg
- Vel Tech Dr. Rangarajan Dr. Sagunthala R&D Institute of Science and Technology, (Veltech Dr. RR and Dr. SR. Technical University), Avadi, Chennai, India
- Kerala Law Academy Law College, Kerala Law Academy Law College Peroorkada, Thiruvananthapuram, Kerala, India
| | - Harika Sapa
- Department of Cardiovascular and Thoracic Surgery (C.V.T.S.), School of Medicine, Amrita Institute of Medical Sciences and Research Centre, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Shona Sara Shaji
- Department of Pharmaceutics, Amrita School of Pharmacy, Amrita Institute of Medical Sciences and Research Centre, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Sreejith T
- Department of Pharmaceutics, Amrita School of Pharmacy, Amrita Institute of Medical Sciences and Research Centre, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Althaf Umar Kp
- Department of Pharmaceutics, Amrita School of Pharmacy, Amrita Institute of Medical Sciences and Research Centre, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Kaladhar K
- Department of Pharmaceutics, Amrita School of Pharmacy, Amrita Institute of Medical Sciences and Research Centre, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Praveen Varma
- Department of Cardiovascular and Thoracic Surgery (C.V.T.S.), School of Medicine, Amrita Institute of Medical Sciences and Research Centre, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Development of Biodegradable Polymeric Stents for the Treatment of Cardiovascular Diseases. Biomolecules 2022; 12:biom12091245. [PMID: 36139086 PMCID: PMC9496387 DOI: 10.3390/biom12091245] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 11/17/2022] Open
Abstract
Cardiovascular disease has become the leading cause of death. A vascular stent is an effective means for the treatment of cardiovascular diseases. In recent years, biodegradable polymeric vascular stents have been widely investigated by researchers because of its degradability and clinical application potential for cardiovascular disease treatment. Compared to non-biodegradable stents, these stents are designed to degrade after vascular healing, leaving regenerated healthy arteries. This article reviews and summarizes the recent advanced methods for fabricating biodegradable polymeric stents, including injection molding, weaving, 3D printing, and laser cutting. Besides, the functional modification of biodegradable polymeric stents is also introduced, including visualization, anti-thrombus, endothelialization, and anti-inflammation. In the end, the challenges and future perspectives of biodegradable polymeric stents were discussed.
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Lee CH, Hsieh MJ, Liu SC, Chen JK, Liu SJ, Hsieh IC, Wen MS, Hung KC. Novel bifurcation stents coated with bioabsorbable nanofibers with extended and controlled release of rosuvastatin and paclitaxel. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 88:61-69. [PMID: 29636139 DOI: 10.1016/j.msec.2018.02.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/29/2017] [Accepted: 02/28/2018] [Indexed: 11/18/2022]
Abstract
A novel bifurcation stent coated with bioabsorbable nanofibers that deliver the extended and controlled release of rosuvastatin and paclitaxel was developed. Bioabsorbable bifurcation stents, consisting of a double-slit tubular main body and two spiral branches, were manufactured. Bi-layered poly (lactic-co-glycolic acid) nanofibers that contained rosuvastatin and paclitaxel were used for treating the stents. Various properties of the fabricated stents, including compression strengths, collapse pressure, water contact angle and flow properties within a circulation model, were quantified. In vitro nanofibrous elution chromatography assays from the drug-loading bifurcation stents were carried out for the release patterns of pharmaceuticals. The effectiveness of eluted rosuvastatin and paclitaxel in inhibiting the adhesion of platelets as well as the proliferation of smooth muscle cells (SMCs) were studied, respectively. The experimental results suggest that bioabsorbable nanofibrous bifurcation stents released high concentrations of rosuvastatin and paclitaxel for 27 and 70 days, respectively. The eluted drugs of rosuvastatin and paclitaxel effectively reduced adherent platelets and the proliferation of SMCs. The developed bioabsorbable nanofibrous bifurcation stents herein may provide a promising means of treating cardiovascular bifurcation lesions.
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Affiliation(s)
- Chen-Hung Lee
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Ming-Jer Hsieh
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Shou-Cheng Liu
- Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan
| | - Jan-Kan Chen
- Department of Physiology and Pharmacology, Chang Gung University, Tao-Yuan, Taiwan
| | - Shih-Jung Liu
- Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
| | - I-Chang Hsieh
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Ming-Shien Wen
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Kuo-Chun Hung
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
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Kraak RP, Grundeken MJ, Onuma Y, Tu S, Wykrzykowska JJ, Chevalier B, Ormiston J, Serruys PW. The future of BRS in bifurcations. EUROINTERVENTION 2015; 11 Suppl V:V188-92. [DOI: 10.4244/eijv11sva45] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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