Biodegradable-Polymer Biolimus-Eluting Stents versus Durable-Polymer Everolimus-Eluting Stents at One-Year Follow-Up: A Registry-Based Cohort Study

Abstract

We compared outcomes of percutaneous coronary intervention patients who received biodegradable-polymer biolimus-eluting stents with those who received durable-polymer everolimus-eluting stents.At C oronary artery stenting is widely accepted as the treatment of choice for most cases of coronary artery disease (CAD). Implantation of the drug-eluting stents (DESs), in comparison with the bare-metal stents (BMS), has conferred better outcomes for coronary artery stenting. [1][2][3][4] Although the administration of the first-generation DES showed a higher rate of success than that of the BMS, doubts were raised over its safety because of the reported cases of late stent thrombosis and very late restenosis. 5 The link between late stent thrombosis and incomplete endothelial coverage of the stent struts caused changes in the design and materials of the platforms and polymers of the stents. 6 Randomized controlled trials and studies have revealed promising results after the implantation of the zotarolimus-and the everolimus-eluting stents, in comparison with the first-generation DES and the BMS.7-9 On the other hand, concerns about late stent failure caused by untoward reactions to the stent polymer led to the introduction of a new-generation DES in which polymers degrade after the termination of drug release. 10 In these stents, drug release lasts about 28 days and an abluminal biodegradable polymer is absorbed after 6 to 9 months, thus turning the DES into a BMS and, theoretically, averting late stent failure as a result of reaction to polymers. Trials have shown the noninferiority of the biodegradable-polymer biolimus-eluting stent (BP-BES) to the previous generations of DESs; however, only a few investigators have compared the biodegradable-polymer with the durable-polymer DES in real-world registries. 11,12 Further analysis of large and

Safety and Performance of Sirolimus-Eluting Coronary Stent System with Biodegradable Polymer: A Retrospective Analysis in Real-World Patient Population

“…Polymers like poly (lactic acid) (PLA), poly (glycolic acid) and their copolymer, poly (lactic-co-glycolic acid) (PLGA), are most prevalent as they sight characteristics to get completely degraded and metabolized in the body [12] [13]. Moreover, biodegradable polymer would have improved safety and performance of DES as they deliver controlled release of anti-restenotic agent and gradual degradation of coating [14] [15]. Hence, efforts to modify or use different coating materials on the stent surface is one of the efficient ways to alter characteristics of the stent surface and enhance the stent's biocompatibility, and consequently reduce the episode of thrombosis and restenosis.…”

One-Year Clinical Outcomes of Biodegradable Polymer-Coated Sirolimus-Eluting Coronary Stent System in Patients with Coronary Artery Disease

“…The use of the biodegradable materials is considered to satisfy the concerns over late stent failure and minimize the risk of thrombus formation [2] [4].…”

“…Therefore, efforts to prevent these risks have promoted the clinicians and stent industry to develop DES with biodegradable polymers with improved stent platforms, effective anti-restenosis drug, and polymer carriers [4]. Additionally, biodegradable polymers provide controlled release of antirestenotic agents and slow degradation of the coating, which would have enhanced the safety and performance of DES [2] [6]. Thus, DES such as Metafor (CE approved) Sirolimus-eluting Coronary Stent (SES) (Meril Life Sciences Pvt.…”

Two years clinical outcomes of patients treated with EucaLimus Sirolimus Eluting Stents. A Real World Experience

“…Polymers like poly (lactic acid) (PLA), poly (glycolic acid) and their copolymer, poly (lactic-co-glycolic acid) (PLGA), are the most adopted, as they can be completely metabolized by the human body [10] [11]. Moreover, biodegradable polymers can improve safety and performance of DES by a slow release of the anti-restenotic agent and, subsequently, a gradual degradation of the coating [12] [13]. In a real-world patient population, biodegradable polymers have demonstrated excellent safety and performance in CAD patients, as quoted by several studies [14] [15].…”