Preclinical research models for evaluating the biocompatibility of bioresorbable metallic cardiovascular stents: A comparative review

Cardiovascular stents are widely used to treat atherosclerosis by relieving vascular obstruction and providing structural support after coronary angioplasty. Bioresorbable metallic stents represent a promising alternative to conventional corrosion-resistant stents, which are linked to late-stage complications such as in-stent restenosis and thrombosis. Due to the diversity of stent materials and designs, rigorous evaluation of their interactions with the vascular environment in relevant preclinical models is essential before clinical translation. However, current studies employ highly variable in vitro cell systems, in vivo animal models, and experimental assays to assess biocompatibility, making it difficult to draw definitive conclusions about candidate designs. This review outlines the current landscape of bioresorbable metallic stents, critically examines the strengths and limitations of preclinical models described in the literature and in international guidelines, and provides recommendations to guide future research in this rapidly evolving field.