Estudo comparativo randomizado do implante de Stent de aço inoxidável recoberto por carbono semelhante ao diamante versus não recoberto em pacientes com doença arterial coronariana

Meireles, George César Ximenes; Abreu, Luciano Mauricio de; Forte, Antonio Artur da Cruz; Sumita, Marcos Kiyoshi; Sumita, Jorge Hideki; Aliaga, José Del Carmen Solano

doi:10.1590/s0066-782x2007000400004

Cited by 13 publications

(6 citation statements)

References 27 publications

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“…However, the initial clinical results seem promising, and long term studies should provide the safety and efficacy data needed. 136 To reduce in-stent restenosis, new trends combine a thromboresistant stent coating with a drug release system. Stents coated with drugs (sirolimus, paclitaxel, actinomycin D, tacrolimus, estradiol, dexamethasone) acting as inhibitors of the cell migration and cell cycle progression with antiproliferative and anti-inflammatory activities are under evaluation in many clinical trails.…”

Section: Discussionmentioning

confidence: 99%

Review of stent coating strategies: Clinical insights

Sydow-Plum¹,

Tabrizian²

2008

Materials Science and Technology

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Despite advances in stent design, expansion techniques and anti-thrombotic agents to improve pharmacological control of subacute thrombosis (SAT) and to reduce to 2 the occlusive thrombosis rates, a significant risk of mortality associated with thrombotic vascular occlusion due to the adhesion of blood constituents remains a problem for patients with more complex lesions. The adhesion process is greatly governed by the surface characteristics, mainly the surface chemical composition, surface morphology, presence of charge, surface wettability and surface roughness. Surface chemical inertness (reduced interaction with chemicals and biological components) subsequently became the primary criteria which guided the development of non thrombotic stents as well as other blood-contacting materials. A number of strategies have been adopted in an effort to coat the stent with or without the use of a drug delivery system, to overcome the thrombus formation, to minimize the stent occlusion and to improve the overall hemocompatibility of the device. This paper aims at reviewing the clinical outcomes of main nonpharmaceutical stent coating procedures and their clinical outcomes. New stents which combine the anti-thrombotic coating with the drug delivery ability, such as radioactive stents, degradable stents and some new challenging trends which are mostly at research and development stage for stent surface coatings are also introduced.

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Section: Discussionmentioning

confidence: 99%

Review of stent coating strategies: Clinical insights

Sydow-Plum¹,

Tabrizian²

2008

Materials Science and Technology

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“…Earlier efforts focused on therapeutic effects such as reduced restenosis, using 1) inorganic coatings, including diamond-like carbon (Airoldi et al, 2004), pyrolytic carbon (Danzi et al, 2004), titanium nitride oxide (Windecker et al, 2005), and carbide (Unverdorben et al, 2003); 2) gene-eluting coatings, incorporating mRNA, siRNA, miRNA, or plasmid DNA of therapeutic genes in the coating; (Feldman et al, 2000;Sharif et al, 2012;Wang et al, 2021) 3) cell-seeded stent, using endothelial cells or progenitor cells (Zhu et al, 2008;Shi et al, 2010;Jantzen et al, 2011;Raina et al, 2014). The inorganic coatings provided ineffective or inconclusive performance (e.g., restenosis rate), compared to uncoated BMS (Kim et al, 2005;Meireles et al, 2007;O'Brien and Carroll, 2009). The gene-eluting coatings, like DES, incorporate genes for therapeutic moiety, but offer a longer term efficacy and a wider variety of therapeutic strategies beyond suppressing cell proliferation for restenosis inhibition (Yang et al, 2013;Adeel and Sharif, 2016;Fishbein et al, 2017;Hytönen et al, 2018).…”

Section: Regenerative Stent Surfacementioning

confidence: 99%

Applying Principles of Regenerative Medicine to Vascular Stent Development

Parthiban

Rafuse

Johnson

et al. 2022

Front. Bioeng. Biotechnol.

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Stents are a widely-used device to treat a variety of cardiovascular diseases. The purpose of this review is to explore the application of regenerative medicine principles into current and future stent designs. This review will cover regeneration-relevant approaches emerging in the current research landscape of stent technology. Regenerative stent technologies include surface engineering of stents with cell secretomes, cell-capture coatings, mimics of endothelial products, surface topography, endothelial growth factors or cell-adhesive peptides, as well as design of bioresorable materials for temporary stent support. These technologies are comparatively analyzed in terms of their regenerative effects, therapeutic effects and challenges faced; their benefits and risks are weighed up for suggestions about future stent developments. This review highlights two unique regenerative features of stent technologies: selective regeneration, which is to selectively grow endothelial cells on a stent but inhibit the proliferation and migration of smooth muscle cells, and stent-assisted regeneration of ischemic tissue injury.

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“…[152] Similarly, the Diamond Flex AS and Phytis stents (Phytis Medical Devices GmbH, Berlin, Germany) compared against bare SS and Multi-Link Penta SS, respectively, showed no significant differences in angiographic restenosis rates. [11,153,154] Titanium-nitride-oxide (TiNOX) coatings have also been developed with the hope that nitrogen in the oxide layer will be a source to facilitate the evolution of nitric oxide (NO), which is known to support endothelial function and improve vasodilation. [11] Several clinical studies have shown that these titanium-nitride-oxide stents reduce restenosis and MACE, [155,156] even when compared against DES.…”

Section: Permanent Metallicsmentioning

confidence: 99%

Designing Better Cardiovascular Stent Materials: A Learning Curve

Cockerill

See

Young

et al. 2020

Adv Funct Materials

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Cardiovascular stents are life‐saving devices and one of the top ten medical breakthroughs of the 21st century. Decades of research and clinical trials have taught us about the effects of material (metal or polymer), design (geometry, strut thickness, and the number of connectors), and drug‐elution on vasculature mechanics, hemocompatibility, biocompatibility, and patient health. Recently developed novel bioresorbable stents are intended to overcome common issues of chronic inflammation, in‐stent restenosis, and stent thrombosis associated with permanent stents, but there is still much to learn. Increased knowledge and advanced methods in material processing have led to new stent formulations aimed at improving the performance of their predecessors but often comes with potential tradeoffs. This review aims to discuss the advantages and disadvantages of stent material interactions with the host within five areas of contrasting characteristics, such as 1) metal or polymer, 2) bioresorbable or permanent, 3) drug elution or no drug elution, 4) bare or surface‐modified, and 5) self‐expanding or balloon‐expanding perspectives, as they relate to pre‐clinical and clinical outcomes and concludes with directions for future studies.

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Estudo comparativo randomizado do implante de Stent de aço inoxidável recoberto por carbono semelhante ao diamante versus não recoberto em pacientes com doença arterial coronariana

Abstract: SummaryObjective: To compare restenosis and major cardiac event rates at one and six months after DLC-coated stent implantation with those of uncoated stents. Méthods

Cited by 13 publications

References 27 publications

Review of stent coating strategies: Clinical insights

Review of stent coating strategies: Clinical insights

Applying Principles of Regenerative Medicine to Vascular Stent Development

Designing Better Cardiovascular Stent Materials: A Learning Curve

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