Abstract
Drug-eluting stents have revolutionised the treatment of coronary artery disease. These small medical devices have attracted much interest over the past decade from biologists, clinicians, engineers and mathematicians alike. This article provides a comprehensive review of the modelling of drug release from arterial stents and the subsequent drug transport through arterial tissue, and acts as a useful reference equally for those who are already involved in drug-eluting stents research and for those who are starting out in the field. Assembled in this review are the main models of drug release and arterial drug transport that have been published in the literature to date. Many of the models presented in this paper have evolved from drug transport models in other applications. Furthermore, the ideas presented in this review may also be extended to other drug-delivery applications, such as drug coated balloons, transdermal patches and therapeutic contact lenses.
Highlights
Introduction and BackgroundArterial stents have revolutionised the treatment of coronary heart disease (CHD)
The wave of arterial stents included a drug designed to prevent the occurrence of restenosis: these are the so-called drug-eluting stents (DESs)
The development of these stents threw up all sorts of questions such as: What type of drug should be used? How much drug should be coated on the stent? How will the drug release be controlled? Effective DES design became the priority for many of the top medical device companies, with considerable budgets spent on developing these products
Summary
Arterial stents have revolutionised the treatment of coronary heart disease (CHD). Acting as a supporting scaffold, these small mesh devices are routinely inserted into arteries where the blood flow has become dangerously restricted (see Fig. 1). Arterial stents have evolved from mere bare metal scaffolds to polymer coated drug-delivery vehicles and, more recently, sophisticated fully biodegradable drug delivery configurations The driver behind these continuing advances is the desire to improve clinical outcomes. The second-generation DESs Endeavor (zotarolimus-eluting; Medtronic), Promus (everolimus-eluting; Boston Scientific Corporation) and Xience V (everolimus eluting; Abbott Laboratories) attempted to improve the biocompatibility and reduce the incidence of thrombosis which was associated with first-generation DES [3,4]. These stents were generally designed with thinner struts and utilised cobalt-chromium and platinum chromium platforms. The models presented here may differ in notation from the original work
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