Related Experiment Video
Updated: May 31, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Biodegradable Stents in the Treatment of Arterial Stenosis
1INVAMED Medical Innovation Institute, New York, NY 10007, USA.
Insights
Bioresorbable vascular stents (BVSs) show promise for treating arterial diseases but face challenges like scaffold thrombosis. Current evidence does not yet support BVS superiority over drug-eluting stents (DESs) in randomized trials.
Area of Science:
- Cardiovascular Medicine and Interventional Cardiology
- Biomaterials and Medical Device Engineering
Background:
- Arterial diseases (ADs) present significant mortality and morbidity challenges.
- Endovascular interventions like balloon angioplasty (BA), bare-metal stents (BMSs), drug-eluting stents (DESs), and drug-coated balloons (DCBs) have advanced treatment but restenosis persists.
- Bioresorbable vascular stents (BVSs) are being investigated as a novel therapeutic approach.
Purpose of the Study:
- To review and assess the current use and challenges of bioresorbable vascular stents (BVSs) in endovascular treatment.
- To compare the efficacy and safety of BVSs against existing endovascular devices, particularly DESs.
- To identify future research directions for optimizing BVS technology.
Main Methods:
- Review of literature and clinical studies on bioresorbable vascular stents (BVSs).
- Analysis of challenges associated with BVSs, including negative vascular remodeling, elastic recoil, and scaffold thrombosis.
- Comparison of BVS performance against bare-metal stents (BMSs) and drug-eluting stents (DESs).
Main Results:
- BVSs face challenges including lower support strength and increased risk of scaffold thrombosis.
- Drug-eluting stents (DESs) remain the preferred choice due to their effectiveness in mitigating restenosis, despite limitations like late stent thrombosis.
- Randomized trials have not yet demonstrated the superiority of BVSs over DESs.
Conclusions:
- While BVSs offer potential advantages, significant challenges require further investigation and technological enhancement.
- The approval of Esprit BTK for below-knee lesions in 2024 indicates progress, but broader application requires more data.
- Large-scale, long-term comparative studies are essential to establish the definitive role of BVSs in treating vascular stenosis.
Abstract:
Arterial diseases (ADs) are a significant health problem, with high mortality and morbidity rates. Endovascular interventions, such as balloon angioplasty (BA), bare-metal stents (BMSs), drug-eluting stents (DESs) and drug-coated balloons (DCBs), have made significant progress in their treatments. However, the issue has not been fully resolved, with restenosis remaining a major concern. In this context, bioresorbable vascular stents (BVSs) have emerged as a promising area of investigation. This manuscript includes articles that assess the use of BVSs. Studies have identified ongoing challenges, such as negative vascular remodeling and elastic recoil post-angioplasty, stent-related injury, and in-stent restenosis following BMS placement. While DESs have mitigated these issues to a considerable extent, their durable structures are unable to prevent late stent thrombosis and delay arterial recovery. BVSs, with their lower support strength and tendency towards thicker scaffolds, increase the risk of scaffold thrombosis. Despite inconsistent study results, the superiority of BVSs over DESs has not been demonstrated in randomized trials, and DES devices continue to be the preferred choice for most cases of arterial disease. Esprit BTK (Abbott Vascular) received approval from the US FDA for below-knee lesions in 2024, offering hope for the use of BVSs in other vascular conditions. Enhancing the design and thickness of BVS scaffolds may open up new possibilities. Large-scale and longer-term comparative studies are still required. This article aims to provide an overview of the use of biodegradable stents in the endovascular treatment of vascular stenosis.
