Advanced Stents for Cardiovascular Applications

  • Mahmoud A. Elnaggar
  • Yoon Ki Joung
  • Dong Keun Han
Chapter
First Online:
Part of the Biosystems & Biorobotics book series (BIOSYSROB, volume 9)

Abstract

Over the past decades, there has been significant evolution in coronary stents used in percutaneous coronary intervention. These coronary stents were developed to prevent the recoil and acute closure that limited the effectiveness of angioplasty. New problems of in-segment restenosis and stent thrombosis emerged despite the advantages of bare metal stents (BMS) for these issues. Antiplatelet therapy and better stent ballooning strategies decreased complications; however, restenosis remained a problem until the development of drug-eluting stents (DES). First generation sirolimus- and paclitaxel-eluting stents were very successful in lowering restenosis, but still other safety concerns emerged, in particular, higher rates of late stent thrombosis. This led to the continuous research and development of new types of DES, and the birth of fully biodegradable stent platforms, which is foreseen to truly overcome the obstacle of having a permanent polymer and metallic stent remaining in the vessel wall that may precipitate sustained inflammation, persistent vasomotor dysfunction, and in-stent neo-atherosclerosis. In this chapter, we will cover the wide spectrum of advancements in stent technologies, and the approaches that were undertaken to surmount the issues that arose with the use of the various devices in vivo, such as material, design, drugs etc., until the most recent ones, an overview of the biological background for the use of percutaneous coronary intervention, and the complications that appear through the use of the different generations of stents.

Keywords

Coronary stent Bare metal stent Drug-eluting stent Restenosis Late thrombosis Bioabsorbable stent Future generation stent 
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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Mahmoud A. Elnaggar
    • 1
    • 2
  • Yoon Ki Joung
    • 1
    • 2
  • Dong Keun Han
    • 1
    • 2
  1. 1.Center for Biomaterials, Biomedical Research InstituteKorea Institute of Science and TechnologySeoulRepublic of Korea
  2. 2.Department of Biomedical EngineeringKorea University of Science and TechnologyYuseong-gu, DaejeonRepublic of Korea

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