Biodegradable stents for coronary artery disease treatment: Recent advances and future perspectives

Abstract

Cardiovascular diseases are one of the major causes of human death in the world. Endovascular stents are the most important implantation devices in cardiovascular intervention, and their efficacy determines the success of cardiovascular disease treatment. In order to reduce the long-term side effects of permanent metallic stents, such as subacute thrombosis and in-stent restenosis, a new generation of endovascular stents so-called “biodegradable stents (BDSs)” is currently being vigorously developed and considered as the most promising candidate. BDS research in the last two decades has been mainly focused on biodegradable polymeric, iron-, magnesium- and zinc-based stent materials. In this review, we first summarized the properties of various BDSs, such as mechanical property, degradation performance, biocompatibility, etc. We then illustrated the working principle of BDSs and their desirable features, which require a compromise between radial support and degradation. We finally discussed the future research strategies in successful BDS development, including the oprimization of stent structures using finite element design, and the improvement in the mechanical properties/corrosion performance/biocompatibility, as well as the drug loading design on BDSs. We also addressed the limitation and deficiency of existing BDSs in order to overcome them in future BDS development and applications.