Research Paper on From a Basic and Clinical Perspective, Understanding the Effect of Stent and Scaffold Material and Strut Design on Coronary Artery Thrombosis

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Title: From a Basic and Clinical Perspective, Understanding the Effect of Stent and Scaffold Material and Strut Design on Coronary Artery Thrombosis

Abstract: To address the limitations of current technologies, percutaneous coronary intervention (PCI) technology is constantly being improved. although the present generation Although metallic drug-eluting stents (DES) function admirably in the short term, questions remain regarding their long-term efficacy. It is still possible to experience late clinical complications, such as late stent thrombosis (ST), restenosis, and neoatherosclerosis, and many of these occurrences may be related to the metallic platform and/or the medication and polymer that were left behind in the arterial wall. The idea of totally bioresorbable vascular scaffolds (BRS) was developed to get around this restriction with the theory that by removing prolonged exposure of the vessel wall to the metal backbone, drug, and polymer, late outcomes would improve. The most sophisticated attempt to create such a device was the absorb-bioabsorbable vascular scaffold (Absorb-BVS), which had thicker struts, more vessel surface area coverage, and less radial force than current DES. Sadly, almost a year after the United States’ initial approval Due to concerns about scaffold thrombosis (ScT), which was observed in both early and late time points, the Food and Drug Administration withdrew this scaffold from the market. Furthermore, the precise causes of ScT are still not fully understood. In this review, we focus on the material/design and the mechanisms of thrombotic complications from the pre-clinical, pathologic, and clinical viewpoints of past and present metallic coronary stents with the Absorb-BVS and newer generation BRS. The technology of percutaneous coronary intervention (PCI) is constantly being improved to overcome the shortcomings of current technologies. Although metallic drug-eluting stents of the current generation (DES) function admirably in the short term, questions remain regarding their long-term efficacy. It is still possible to experience late clinical complications, such as late stent thrombosis (ST), restenosis, and neoatherosclerosis, and many of these occurrences may be related to the metallic platform and/or the medication and polymer that were left behind in the arterial wall. The idea of totally bioresorbable vascular scaffolds (BRS) was developed to get around this restriction with the theory that by removing prolonged exposure of the vessel wall to the metal backbone, drug, and polymer, late outcomes would improve. The most sophisticated attempt to create such a device was the absorb-bioabsorbable vascular scaffold (Absorb-BVS), which had thicker struts, more vessel surface area coverage, and less radial force than current DES. Sadly, almost a year after the United States’ initial approval Due to concerns about scaffold thrombosis (ScT), which was observed in both early and late time points, the Food and Drug Administration withdrew this scaffold from the market. Furthermore, the precise causes of ScT are still not fully understood. In this review, we focus on the material/design and the mechanisms of thrombotic complications from the pre-clinical, pathologic, and clinical viewpoints. We discuss the platform, vascular response, and clinical data of past and present metallic coronary stents with the Absorb-BVS and newer generation BRS.

Keywords: bioresorbable vascular scaffold; drug eluting stent; polymer; stent thrombosis; scaffold thrombosis

Paper Quality: SCOPUS / Web of Science Level Research Paper

Subject: Bioengineering

Writer Experience: 20+ Years

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