AI Article Synopsis
- - Coronary artery disease (CAD) is a major health issue leading to high mortality rates, with drug-eluting stents (DES) and drug-coated balloons (DCB) being advanced treatment options that release drugs to prevent restenosis after angioplasty.
- - A comprehensive review of various research articles highlights the evolution of DES and DCBs, addressing previous challenges like inflammation and stent thrombosis while improving biocompatibility with newer designs.
- - Despite advancements in DES and DCB technologies, the review emphasizes that challenges still remain in clinical applications, affecting long-term treatment outcomes for patients with CAD.
Article Abstract
Aim: Coronary artery disease (CAD) is the leading cause of mortality. Though percutaneous transluminal angioplasty followed by stenting is still the default treatment of choice for revascularization of obstructive CAD, the high rate of restenosis compromises the outcomes of endovascular procedures. To overcome restenosis, drug-eluting stents (DES) and drug-coated balloons (DCB) are designed that release antiproliferative drugs like sirolimus, paclitaxel, everolimus, etc., over time to inhibit cell growth and proliferation. Our review aims to summarize the challenges and progress of DES/DCBs in clinical settings.
Material And Methods: The comprehensive review, search and selection encompasses in relevant articles through Google Scholar, Springer online, Cochrane library and PubMed that includes research articles, reviews, letters and communications, various viewpoints, meta-analyses, randomized trials and quasi-randomized trials. Several preclinical and clinical data have been included from National Institutes of Health and clinicaltrials.gov websites.
Key Findings: Challenges like delayed endothelialization, stent thrombosis (ST), and inflammation was prominent in first-generation DES. Second-generation DES with improved designs and drug coatings enhanced biocompatibility with fewer complications. Gradual absorption of bioresorbable DES over time mitigated long-term issues associated with permanent implants. Polymer-free DES addressed the inflammation concerns but still, they leave behind metallic stents in the vasculature. As an alternative therapeutic strategy, DCB were developed to minimize inflammation in the vessel. Although both DES and DCBs have shown considerable progress, challenges persist.
Significance: This review illustrates the advancements in the designs, preparation technologies, biodegradable materials, and drugs used as well as challenges associated with DES and DCBs in clinical settings.
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| http://dx.doi.org/10.1016/j.lfs.2024.122908 | DOI Listing |
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