First-in-man use of polymer-free valsartan-eluting stents in small coronary vessels: a comparison to polymer-free rapamycin (2%)-eluting stents

Peters, Stefan; Behnisch, Boris; Heilmann, Torsten; Richter, Christian

doi:10.1177/1470320308098591

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…Furthermore, the porous structure retards the release of the drug, due to longer diffusion distances. , Micro- and nanopores as well as other textured rough surfaces can be created by several techniques such as sandblasting and mechanical modification. , The pores, ranging from 1 nm to 100 μm in size, serve as a reservoir for the drugs and drug loadings up to 500 μg/mm 2 can be achieved . The microporous surface of the stent will also induce its endothelization and can therefore reduce neointima formation. , Polymer-free stents with microporous surfaces showed equal drug loadings as stents coated with polymers. − …”

Section: Coating Technologiesmentioning

confidence: 99%

Polymer-Free Drug-Eluting Stents: An Overview of Coating Strategies and Comparison with Polymer-Coated Drug-Eluting Stents

et al. 2015

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Clinical evaluations have proven the efficacy of drug-elution stents (DES) in reduction of in-stent restenosis rates as compared to drug-free bare metal stents (BMS). Typically, DES are metal stents that are covered with a polymer film loaded with anti-inflammatory or antiproliferative drugs that are released in a sustained manner. However, although favorable effects of the released drugs have been observed, the polymer coating as such has been associated with several adverse clinical effects, such as late stent thrombosis. Elimination of the polymeric carrier of DES may therefore potentially lead to safer DES. Several technologies have been developed to design polymer-free DES, such as the use of microporous stents and inorganic coatings that can be drug loaded. Several drugs, including sirolimus, tacrolimus, paclitaxel, and probucol have been used in the design of carrier-free stents. Due to the function of the polymeric coating to control the release kinetics of a drug, polymer-free stents are expected to have a faster drug elution rate, which may affect the therapeutic efficacy. However, several polymer-free stents have shown similar efficacy and safety as the first-generation DES, although the superiority of polymer-free DES has not been established in clinical trials.

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Section: Coating Technologiesmentioning

confidence: 99%

Polymer-Free Drug-Eluting Stents: An Overview of Coating Strategies and Comparison with Polymer-Coated Drug-Eluting Stents

et al. 2015

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Non-polymer drug-eluting coronary stents

Kommineni

Raju

Khan

et al. 2017

Drug Deliv. and Transl. Res.

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Cardiovascular complications are leading causes of most fatalities. Coronary artery disease and surgical failures contribute to the death of the majority of patients. Advanced research in the field of medical devices like stents has efficiently resolved these problems. Clinically, drug-eluting stents have proven their efficacy and safety compared to bare metal stents, which have problems of in-stent restenosis. However, drug-loaded stents coated with polymers have shown adverse effects related to the stability and deterioration of the polymer coating over time. This results in late stent thrombosis and immunogenicity. These reasons laid the foundation for the development of non-polymeric drug-eluting stents. This review focuses on non-polymer drug-eluting stents loaded with different drugs like anti-inflammatory agents, anti-thrombotic, anti-platelet agents, immune suppressants and others. Surface modification techniques on stents like crystalline coating; microporous, macroporous, and nanoporous coatings; and chemically modified self-assembled monolayers are described in detail. There is also an update on clinically approved products and those under development.

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Efficacy and safety of a novel nano-porous polymer-free sirolimus-eluting stent in pigs

CHEN,

ZHENG,

et al. 2013

Chinese Medical Journal

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Background Drug-eluting stents represent a major advance in interventional cardiology. However, the current drug-eluting stents have significant limitations. One of the major problems is very late stent thrombosis, which is likely caused by inflammation and a hypersensitivity reaction related to a polymer on the stent. A polymer-free sirolimus-eluting stent with a unique nano-porous surface has been developed. This study aimed to evaluate this novel polymer-free sirolimus-eluting stent for its efficacy and safety in a pig model. Methods Stents were directly coated with sirolimus (a drug concentration of 2.2 μg/mm2 on the stent surface). The polymer-free sirolimus-eluting stents (PFSES) were compared to standard polymer-coated sirolimus-eluting stents (PCSES) and bare-metal stents (BMS) in 18 pigs. Results At one month the degree of neointimal hyperplasia was similar between the two sirolimus-eluting stent groups and was significantly less compared to BMS ((1.93±0.51) mm2, (1.57±0.69) mm2 vs. (4.45±1.05) mm2, P <0.05) At three months, PFSES maintained the low level of neointima ((2.41±0.99) mm2 vs. (4.32±1.16) mm2, P <0.05), whereas PCSES had developed significant neointimal proliferation similar to BMS. The inflammation level was significantly higher in PCSES when compared with BMS three months post-implantation (2.50±0.55 vs. 0.83±0.75, P <0.05) whereas PFSES showed a low level of inflammation comparable to PCSES (1.33±0.52 vs. 2.50±0.55, P <0.05). Conclusion The PFSES is effective and safe, and appears to be superior to standard PCSEs.

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First-in-man use of polymer-free valsartan-eluting stents in small coronary vessels: a comparison to polymer-free rapamycin (2%)-eluting stents

Abstract: If polymer-free YUKON Choice stents are used in small vessels, valsartan-eluting stents show an identical efficacy as rapamycin-loaded stents. In patients with rapamycin-eluting YUKON Choice stents it seems that the efficacy can be increased by oral valsartan administration.

Cited by 3 publications

References 26 publications

Polymer-Free Drug-Eluting Stents: An Overview of Coating Strategies and Comparison with Polymer-Coated Drug-Eluting Stents

Polymer-Free Drug-Eluting Stents: An Overview of Coating Strategies and Comparison with Polymer-Coated Drug-Eluting Stents

Non-polymer drug-eluting coronary stents

Efficacy and safety of a novel nano-porous polymer-free sirolimus-eluting stent in pigs

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