Zusammenfassung
Metallstents werden zunehmend in der Behandlung von vaskulären Erkrankungen eingesetzt, jedoch mit dem Nachteil eines permanenten Fremdkörpers im Organismus, wodurch die Gefahr einer Spätthrombosierung oder Neointimaausbildung besteht. Das anschließende Remodelling ist jedoch nur ein temporärer Vorgang, weshalb der Stent als Gefäßstütze nur vorübergehend benötigt wird. Ein biodegradierbarer, sich auflösender Stent stellt daher eine Alternative zum herkömmlichen Metallstent dar. Biodegradierbare Polylactidstents haben ihr Potenzial als Alternative zu Metallstents bereits demonstriert, allerdings sind bis zum heutigen Tag klinische Erfahrungen nur sehr begrenzt vorhanden. Die wissenschaftliche Zielsetzung der vorliegenden Arbeit lag daher in der tierexperimentellen Charakterisierung der physikalischen und biologischen Eigenschaften eines biodegradierbaren Röhrchenstents aus Poly-L-Lactid (PLLA) mit und ohne Sirolimusbeschichtung (polymerer Drug-eluting-Stent).
Abstract
Although vascular intervention using metal stents has become the gold standard of care for stenotic vessels, the lifelong persistence of metal stents within the arteries might induce long-term effects, bearing the risk of late thrombosis finally resulting in neointimal hyperplasia. However, since the vessel wall may undergo positive remodeling after stenting, the need for mechanical scaffolding of an artery may be only temporary. Thus, the use of biodegradable devices, which eventually degrade and leave only the remodeled vessel, might decrease restenosis rates. Polymeric biodegradable polylactide stents have demonstrated this potential as an alternative to standard metal stents, but to date, the human experiences with these devices are limited. The aim of this study was therefore to summarize our experiences in dealing with a biodegradable slotted tube stent made of poly-L-lactide (PLLA) with incorporation of Sirolimus (polymeric drug eluting stent).
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Danksagung
Diese Arbeit wurde unterstützt durch die „Fakultätsinterne Forschungsförderung“ (FORUN 989057, 989046) der Universität Rostock. Die tierexperimentellen Arbeiten erfolgten in enger Zusammenarbeit mit dem Institut für experimentelle Chirurgie mit zentraler Versuchstierhaltung der Universität Rostock (Direktor: Prof. Dr. med. B. Vollmar). Frau Anne-Marie Beck, Leibniz-Forschungslaboratorien der Klinik für Thorax-, Herz- und Gefäßchirurgie der Medizinischen Hochschule Hannover, verdanken wir die Einbettung und das Schneiden der stenttragenden Gewebeproben, Herrn Wodetzki die exzellente grafische Darstellung des Stent-Prothesen-Modells.
Wir danken dem Journal of Endovascular Therapy (©International Society of Endovascular Specialists) für die Erlaubnis zur partiellen Reproduktion aus den Manuskripten [1, 2, 5].
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Bünger, C., Grabow, N., Sternberg, K. et al. Temporäre Implantate für die endovaskuläre Applikation. Gefässchirurgie 13, 99–106 (2008). https://doi.org/10.1007/s00772-008-0586-8
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DOI: https://doi.org/10.1007/s00772-008-0586-8