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Biocompatibility of Coronary Stents
The Heart Research Institute, Sydney NSW 2042, Australia
Sydney Medical School, University of Sydney, Sydney NSW 2006, Australia
School of Molecular Bioscience, University of Sydney, Sydney NSW 2006, Australia
Department of Cardiology, Royal Prince Alfred Hospital, University of Sydney, Sydney NSW 2050, Australia
* Author to whom correspondence should be addressed.
Received: 24 December 2013; in revised form: 20 January 2014 / Accepted: 20 January 2014 / Published: 28 January 2014
Abstract: Cardiovascular disease is the dominant cause of mortality in developed countries, with coronary artery disease (CAD) a predominant contributor. The development of stents to treat CAD was a significant innovation, facilitating effective percutaneous coronary revascularization. Coronary stents have evolved from bare metal compositions, to incorporate advances in pharmacological therapy in what are now known as drug eluting stents (DES). Deployment of a stent overcomes some limitations of balloon angioplasty alone, but provides an acute stimulus for thrombus formation and promotes neointimal hyperplasia. First generation DES effectively reduced in-stent restenosis, but profoundly delay healing and are susceptible to late stent thrombosis, leading to significant clinical complications in the long term. This review characterizes the development of coronary stents, detailing the incremental improvements, which aim to attenuate the major clinical complications of thrombosis and restenosis. Despite these enhancements, coronary stents remain fundamentally incompatible with the vasculature, an issue which has largely gone unaddressed. We highlight the latest modifications and research directions that promise to more holistically design coronary implants that are truly biocompatible.
Keywords: coronary artery disease; biofunctionalization; stent; thrombosis; restenosis
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MDPI and ACS Style
Jeewandara, T.M.; Wise, S.G.; Ng, M.K.C. Biocompatibility of Coronary Stents. Materials 2014, 7, 769-786.
Jeewandara TM, Wise SG, Ng MKC. Biocompatibility of Coronary Stents. Materials. 2014; 7(2):769-786.
Jeewandara, Thamarasee M.; Wise, Steven G.; Ng, Martin K.C. 2014. "Biocompatibility of Coronary Stents." Materials 7, no. 2: 769-786.