Abstract
Over the past years the development of biodegradable polymeric stents has made great progress; nevertheless, essential problems must still be solved. Modifications in design and chemical composition should optimize the quality of biodegradable stents and remove the weaknesses. New biodegradable poly-L-lactide/poly-4-hydroxybutyrate (PLLA/P4HB) stents and permanent 316L stents were implantedendovascularly into both common carotid arteries of 10 domestic pigs. At 4 weeks following implantation, computed tomography (CT) angiography was carried out to identify the distal degree of stenosis. The PLLA/P4HB group showed a considerably lower distal degree of stenosis by additional oral application of atorvastatin (mean 39.81 ± 8.57 %) compared to the untreated PLLA/P4HB group without atorvastatin (mean 52.05 ± 5.80 %). The 316L stents showed no differences in the degree of distal stenosis between the group treated with atorvastatin (mean 44.21 ± 2.34 %) and the untreated group (mean 35.65 ± 3.72 %). Biodegradable PLLA/P4HB stents generally represent a promising approach to resolving the existing problems in the use of permanent stents. Restitutio ad integrum is only achievable if a stent is completely degraded.
Highlights
Materials and methodsAnimal preparationThe ability to treat vascular disease using interventional approaches, as well as and the development of endovascular treatment techniques have made the use of stents routine
Biodegradable PLLA/P4HB stents were successfully implanted in the CCA of domestic swine using an endovas
The present study showed a significantly lower degree of distal stenosis in animals treated with oral atorvastatin compared with untreated animals in the PLLA/P4HB group at contrast-enhanced computed tomography (CT) 4 weeks following implantation
Summary
The ability to treat vascular disease using interventional approaches, as well as and the development of endovascular treatment techniques have made the use of stents routine. Compared with single-vessel dilatation, as in percutaneous transluminal angioplasty (PTA), they prevent in particular acute vascular recoil by providing scaffolding, thereby effectively reducing the restenosis rate [1]. Alongside permanent bare metal stents (BMS) of various designs, alloys and applications, biodegradable polymer stents are playing an ever more important role. Compared with conventional permanent BMS, they have the advantage of preventing chronic foreign-body reactions and enabling secondary vascular surgery in previously stented areas. The aim of this article is to present the results from an animal model following endovascular implantation of an advanced and improved biodegradable PLLA/P4HB stent compared with a permanent 316L metal stent for use in the peripheral vasculature. The effect of an orally administered statin is investigated
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