Second generation drug-eluting stents: a focus on safety and efficacy of current devices

Spione, Francesco; Brugaletta, Salvatore

doi:10.1080/14779072.2021.1874352

Cited by 4 publications

(5 citation statements)

References 143 publications

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“…To overcome these complications, the second-or newer-generation DES has been investigated with improved stent platforms, biocompatible, durable, or biodegradable polymers, and newer antiproliferative agents, even new technologies, such as ultrathin strut and polymer-free DES, which were developed and assessed by several patients at high risk of bleeding, avoiding bleeding complications. It could also be applied in more complex lesions, such as left main artery lesions, bifurcation, dissection, and calcification with the help of other devices (29)(30)(31). There were also some limitations of DES as mentioned before, and more studies on the newer-generation DES were needed to assess the efficacy and safety.…”

Section: Discussionmentioning

confidence: 99%

Drug-Coated Balloon vs. Stent for de novo Non-small Coronary Artery Disease: A Systematic Review and Meta-Analysis

Sun

Liu

Wang

2021

Front. Cardiovasc. Med.

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Introduction: Drug-coated balloon (DCB) has been an attractive option in de novo vessels. A systematic review and meta-analysis were conducted to evaluate the efficacy and safety of DCB vs. stent for treating de novo lesions in non-small vessels.Methods: Studies in PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science were searched (from their commencement to March 2021). This meta-analysis was performed by Review Manager 5.3.Results: A total of 3 random controlled trials (RCTs) with 255 patients and 2 observational studies (OS) with 265 patients were included in this meta-analysis following our inclusion criteria. It could be observed that DCB presented no significant difference in cardiac death (CD) (RR 0.33, 95% CI [0.01, 8.29], p = 0.50 in OS), myocardial infarction (MI) (RR 0.49, 95% CI [0.09, 2.50], p = 0.39 in RCT), target lesion revascularization (TLR) (RR 0.64, 95% CI [0.19, 2.18], p = 0.47 in RCT) (RR 1.72, 95% CI [0.56, 5.26], p = 0.34 in OS), and late lumen loss (LLL) (SMD −0.48, 95% CI [−1.32, 0.36], p = 0.26 in RCT) for de novo non-small coronary artery disease (CAD) compared with stents, whereas minimal lumen diameter (MLD) including MLD1 (SMD −0.67, 95% CI [−0.92 −0.42], p < 0.00001 in RCT) and MLD2 (SMD −0.36, 95% CI [−0.61 −0.11], p = 0.004 in RCT) was smaller in DCB group.Conclusion: This systematic review showed that DCB might provide a promising way on de novo non-small coronary artery disease compared with stents. However, more RCTs are still needed to further prove the benefits of the DCB strategy.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/#recordDetails.

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Section: Discussionmentioning

confidence: 99%

Drug-Coated Balloon vs. Stent for de novo Non-small Coronary Artery Disease: A Systematic Review and Meta-Analysis

Sun

Liu

Wang

2021

Front. Cardiovasc. Med.

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“…[37] Regarding the different generations of DES, the first-generation DES (e.g., Cypher and Taxus) adopted the 316 L stainless steel with relatively thick structs around 130-140 µm, [23,24] while newer-generation DES (e.g., Driver, Xience Sierra, Resolute Onyx) possessed thinner cobalt-chromium alloy strut around 80 µm. [26,38] Some preclinical studies revealed that thick-strut stents might have greater thrombogenicity than that with thinner-strut stents, because of the possible accumulation of procoagulant and proinflammatory elements, which might in turn increase the risk of restenosis due to neointimal hyperplasia. [39] More importantly, endothelialization rate was also lower on the stents with thicker struts.…”

Section: Stent Design Of Desmentioning

confidence: 99%

Development of Innovative Biomaterials and Devices for the Treatment of Cardiovascular Diseases

Wang

Yang

et al. 2022

Advanced Materials

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Cardiovascular diseases have become the leading cause of death worldwide. The increasing burden of cardiovascular diseases has become a major public health problem and how to carry out efficient and reliable treatment of cardiovascular diseases has become an urgent global problem to be solved. Recently, implantable biomaterials and devices, especially minimally invasive interventional ones, such as vascular stents, artificial heart valves, bioprosthetic cardiac occluders, artificial graft cardiac patches, atrial shunts, and injectable hydrogels against heart failure, have become the most effective means in the treatment of cardiovascular diseases. Herein, an overview of the challenges and research frontier of innovative biomaterials and devices for the treatment of cardiovascular diseases is provided, and their future development directions are discussed.

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“…2 Introduction to the clinical practice of the second generation of DES resulted in even higher safety and efficacy. 3 Despite the undeniable evolution of DES technology, it still shows some limitations, 4 such as hypersensitivity reactions, late stent thrombosis and restenosis, progression of atherosclerosis (neoatherosclerosis), and impairment of vasomotor vessel function. To overcome these limitations, bioresorbable vascular scaffolds (BRS) were designed as a vessel-supporting technology allowing for anatomical and functional restoration of the vessel after the scaffold intended resorption.…”

Section: Introductionmentioning

confidence: 99%

“…Widespread use of intracoronary stents—initially bare metal (BMS) subsequently replaced with the first generation of drug‐eluting stents (DES) allowed to achieve reasonable short‐ and long‐term outcomes 2 . Introduction to the clinical practice of the second generation of DES resulted in even higher safety and efficacy 3 . Despite the undeniable evolution of DES technology, it still shows some limitations, 4 such as hypersensitivity reactions, late stent thrombosis and restenosis, progression of atherosclerosis (neoatherosclerosis), and impairment of vasomotor vessel function.…”

Section: Introductionmentioning

confidence: 99%

The bioresorbable magnesium scaffold (Magmaris)—State of the art: From basic concept to clinical application

Rola

Włodarczak²,

Doroszko

et al. 2022

Cathet Cardio Intervent

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Since its introduction to clinical practice, coronary artery stent implantation has become a crucial part of the therapy of coronary artery disease (CAD). Despite the undeniable evolution of percutaneous coronary revascularization procedures, drugeluting stent (DES) technology shows some limitations. To overcome these limitations bioresorbable vascular scaffolds (BRS) were designed as a vesselsupporting technology allowing for anatomical and functional restoration of the vessel after the scaffold intended resorption. Various materials have been proposed as the basis of the scaffold backbone. In this narrative review, we present secondgeneration magnesium-alloy bioresorbable scaffold devices (Magmaris; Biotronik). Additionally, we discuss available preclinical and clinical data regarding this new magnesium BRS.

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Second generation drug-eluting stents: a focus on safety and efficacy of current devices

Cited by 4 publications

References 143 publications

Drug-Coated Balloon vs. Stent for de novo Non-small Coronary Artery Disease: A Systematic Review and Meta-Analysis

Drug-Coated Balloon vs. Stent for de novo Non-small Coronary Artery Disease: A Systematic Review and Meta-Analysis

Development of Innovative Biomaterials and Devices for the Treatment of Cardiovascular Diseases

The bioresorbable magnesium scaffold (Magmaris)—State of the art: From basic concept to clinical application

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