Drug-eluting biostable and erodible stents

Huang, Yingying; Ng, Herr Cheun Anthony; Ng, Xu Wen; Venkatraman, Subbu S.

doi:10.1016/j.jconrel.2014.05.011

Cited by 51 publications

(32 citation statements)

References 60 publications

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“…In those cases, the time-dependence of drug release [46] and the process of drug binding to tissue proteins will more accurately determine the ultimate drug uptake [47, 48]. Assuming a more dynamic environment of biological host species, vascular response both to the intravascular implant and depleted drug in terms of intimal hyperplasia and thrombosis should also be included in future numerical models to better assess the efficacy of new generations of drug-eluting implants [49] in more sophisticated clinical routines such as overlap [50, 51]. Developing such an intricate model entails further in vivo studies to acquire empirical factors of the biological response of the artery to develop a multi-scale, multi-modal tool.…”

Section: Discussionmentioning

confidence: 99%

Drug deposition in coronary arteries with overlapping drug-eluting stents

Rikhtegar

Edelman

Olgaç

et al. 2016

Journal of Controlled Release

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Drug-eluting stents are accepted as mainstream endovascular therapy, yet concerns for their safety may be under-appreciated. While failure from restenosis has dropped to below 5%, the risk of stent thrombosis and associated mortality remain relatively high. Further optimization of drug release is required to minimize thrombosis risk while maintaining therapeutic dose. The complex three-dimensional geometry of deployed stents together with the combination of diffusive and advective drug transport render an intuitive understanding of the situation exceedingly difficult. In situations such as this, computational modeling has proven essential, helping define the limits of efficacy, determine the mode and mechanism of drug release, and identify alternatives to avoid toxicity. A particularly challenging conformation is encountered in coronary arteries with overlapping stents. To study hemodynamics and drug deposition in such vessels we combined high-resolution, multi-scale ex vivo computed tomography with a flow and mass transfer computational model. This approach ensures high geometric fidelity and precise, simultaneous calculation of blood flow velocity, shear stress and drug distribution. Our calculations show that drug uptake by the arterial tissue is dependent both on the patterns of flow disruption near the wall, as well as on the relative positioning of drug-eluting struts. Overlapping stent struts lead to localized peaks of drug concentration that may increase the risk of thrombosis. Such peaks could be avoided by anisotropic stent structure or asymmetric drug release designed to yield homogeneous drug distribution along the coronary artery and, at the least, suggest that these issues need to remain in the forefront of consideration in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Drug deposition in coronary arteries with overlapping drug-eluting stents

Rikhtegar

Edelman

Olgaç

et al. 2016

Journal of Controlled Release

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“…These new polyesters may be used as macromolecular carriers for gene therapy, for tissue engineering, and for drug delivery. Indeed, PDMMLA derivatives were synthesized and characterized in order to develop a new bioactive coating to cover a coronary stent and deliver a drug to enable the reduction of intrastent restenosis [96][97][98][99].…”

Section: Interests and Application Of Pdmmlasmentioning

confidence: 99%

“…According to the literature, the polymers used as synthetic matrices for the coating of stents and the release of drugs (PGA, PLA, PCL, etc.) [21,103,104] are not perfect solutions. They have a limited diversity of their structures and adverse reactions can be caused by these polymers [105].…”

Section: Interests and Application Of Pdmmlasmentioning

confidence: 99%

See 1 more Smart Citation

New promising biodegradable polyesters derived from poly((R,S)-3,3-dimethylmalic acid) for cardiovascular applications

Belibel¹,

Barbaud²

2017

Biodegradable Polymers: Recent Developments and New Perspectives

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“…[12][13][14][15][16][17][18]) has received much attention in the literature, the modelling of polymer-free DES has not. This is somewhat surprising, especially since a recent drug-eluting stent review [19] reports that ''. .…”

Section: Introductionmentioning

confidence: 99%

Some design considerations for polymer-free drug-eluting stents: A mathematical approach

McGinty

Meere

et al. 2015

Acta Biomaterialia

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In this paper we provide the first model of drug elution from polymer-free arterial drug-eluting stents. The generalised model is capable of predicting drug release from a number of polymer-free systems including those that exhibit nanoporous, nanotubular and smooth surfaces. We derive analytical solutions which allow us to easily determine the important parameters that control drug release. Drug release profiles are provided, and we offer design recommendations so that the release profile may be tailored to achieve the desired outcome. The models presented here are not specific to drug-eluting stents and may also be applied to other biomedical implants that use nanoporous surfaces to release a drug.

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Drug-eluting biostable and erodible stents

Cited by 51 publications

References 60 publications

Drug deposition in coronary arteries with overlapping drug-eluting stents

Drug deposition in coronary arteries with overlapping drug-eluting stents

New promising biodegradable polyesters derived from poly((R,S)-3,3-dimethylmalic acid) for cardiovascular applications

Some design considerations for polymer-free drug-eluting stents: A mathematical approach

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