Adaptation of Vascular Smooth Muscle Cell to Degradable Metal Stent Implantation

Abstract

Iron-, magnesium-, or zinc-based metal vessel stents support vessel expansion at the period early after implantation and degrade away after vascular reconstruction, eliminating the side effects due to the long stay of stent implants in the body and the risks of restenosis and neoatherosclerosis. However, emerging evidence has indicated that their degradation alters the vascular microenvironment and induces adaptive responses of surrounding vessel cells, especially vascular smooth muscle cells (VSMCs). VSMCs are highly flexible cells that actively alter their phenotype in response to the stenting, similarly to what they do during all stages of atherosclerosis pathology, which significantly influences stent performance. This Review discusses how biodegradable metal stents modify vascular conditions and how VSMCs respond to various chemical, biological, and physical signals attributable to stent implantation. The focus is placed on the phenotypic adaptation of VSMCs and the clinical complications, which highlight the importance of VSMC transformation in future stent design.

Research on the Current Application Status of Magnesium Metal Stents in Human Luminal Cavities

“…Stents, as commonly used intracorporeal implants, perform an essential function in supporting and restoring luminal patency. Figure 1 illustrates that commonly used stents in clinical practice encompass a wide range according to the service environment, such as coronary stents [ 5 ], vascular stents [ 6 ], biliary stents [ 7 ], tracheal stents [ 8 ], esophageal stents [ 9 ], intestinal stents [ 10 ], and urethral stents [ 11 ]. Each location of the lumen has specific requirements for stents, but regardless of the location, good mechanical properties and biocompatibility are fundamental prerequisites.…”