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    Understanding the impact of stent and scaffold material and strut design on coronary artery thrombosis from the basic and clinical points of view

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    Author
    Sakamoto, A.
    Jinnouchi, H.
    Torii, S.
    Date
    2018
    Journal
    Bioengineering
    Publisher
    MDPI AG
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://dx.doi.org/10.3390/bioengineering5030071
    Abstract
    The technology of percutaneous coronary intervention (PCI) is constantly being refined in order to overcome the shortcomings of present day technologies. Even though current generation metallic drug-eluting stents (DES) perform very well in the short-term, concerns still exist about their long-term efficacy. Late clinical complications including late stent thrombosis (ST), restenosis, and neoatherosclerosis still exist and many of these events may be attributed to either the metallic platform and/or the drug and polymer left behind in the arterial wall. To overcome this limitation, the concept of totally bioresorbable vascular scaffolds (BRS) was invented with the idea that by eliminating long-term exposure of the vessel wall to the metal backbone, drug, and polymer, late outcomes would improve. The Absorb-bioabsorbable vascular scaffold (Absorb-BVS) represented the most advanced attempt to make such a device, with thicker struts, greater vessel surface area coverage and less radial force versus contemporary DES. Unfortunately, almost one year after its initial approval by the U.S. Food and Drug Administration, this scaffold was withdrawn from the market due to declining devise utilization driven by the concerns about scaffold thrombosis (ScT) seen in both early and late time points. Additionally, the specific causes of ScT have not yet been fully elucidated. In this review, we discuss the platform, vascular response, and clinical data of past and current metallic coronary stents with the Absorb-BVS and newer generation BRS, concentrating on their material/design and the mechanisms of thrombotic complications from the pre-clinical, pathologic, and clinical viewpoints. Copyright 2018 by the authors. Licensee MDPI, Basel, Switzerland.
    Sponsors
    Funding: This research was funded by CVPath Institute, Inc.
    Keyword
    Bioresorbable vascular scaffold
    Drug eluting stent
    Polymer
    Scaffold thrombosis
    Stent thrombosis
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85056780795&doi=10.3390%2fbioengineering5030071&partnerID=40&md5=4204054feaa9d108ae26548184ab2fbc; http://hdl.handle.net/10713/9063
    ae974a485f413a2113503eed53cd6c53
    10.3390/bioengineering5030071
    Scopus Count
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