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Influences of Stent Design on In-Stent Restenosis and Major Cardiac Outcomes: A Scoping Review and Meta-Analysis
Cardiovascular Engineering and Technology ( IF 1.6 ) Pub Date : 2021-08-18 , DOI: 10.1007/s13239-021-00569-0
Omer Burak Istanbullu 1 , Gulsen Akdogan 1
Affiliation  

Thanks to the developments in implantable biomaterial technologies, invasive operating procedures, and widespread applications especially in vascular disease treatment, a milestone for interventional surgery was achieved with the introduction of vascular stents. Despite vascular stents providing a solution for embolisms, this technology includes various challenges, such as mechanical, electro-chemical complications, or in-stent restenosis (ISR) risks with long-term usage. Therefore, further development of biomaterial technologies is vital to overcome such risks and problems. For this purpose, recent research has focused mainly on the applications of surface modification techniques on biomaterials and vascular stents to increase their hemocompatibility. ISR risk has been reduced with the development and prevalent usage of the art technology stent designs of drug-eluting and biodegradable stents. Nevertheless, their problems have not been overcome completely. Furthermore, patients using drug-eluting stents are faced with further clinical challenges. Therefore, the bare metal stent, which is the first form of the vascular stent technology and includes the highest ISR risk, is still in common usage for vascular treatment applications. For this reason, further research is necessary to solve the remaining vital problems. In this scoping review, stent-based major cardiac events including ISR are analyzed depending on different designs and material selection in stent manufacturing. Recent and novel approaches to overcome such challenges are stated in detail.



中文翻译:

支架设计对支架内再狭窄和主要心脏结局的影响:范围审查和荟萃分析

由于可植入生物材料技术、侵入性手术程序和广泛应用(尤其是在血管疾病治疗中)的发展,血管支架的引入实现了介入手术的里程碑。尽管血管支架为栓塞提供了解决方案,但该技术仍面临各种挑战,例如机械、电化学并发症或长期使用的支架内再狭窄 (ISR) 风险。因此,生物材料技术的进一步发展对于克服这些风险和问题至关重要。为此,最近的研究主要集中在表面改性技术在生物材料和血管支架上的应用,以提高它们的血液相容性。随着药物洗脱和可生物降解支架的现有技术支架设计的发展和普遍使用,ISR 风险已经降低。然而,他们的问题还没有完全解决。此外,使用药物洗脱支架的患者面临着进一步的临床挑战。因此,裸金属支架作为血管支架技术的第一种形式,包括最高的 ISR 风险,仍然普遍用于血管治疗应用。出于这个原因,需要进一步的研究来解决剩下的重要问题。在本次范围审查中,根据支架制造中的不同设计和材料选择,分析了基于支架的主要心脏事件,包括 ISR。详细说明了克服这些挑战的最新和新颖的方法。

更新日期:2021-08-19
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