The current status of biodegradable stent to treat benign luminal disease

Abstract

Stent implantation is a well-accepted alternative to treat benign luminal disease (BLD). Current stents are often fabricated from plastic, mental and biodegradable materials, and the latter two have wider clinical application. Self-expanding plastic and mental stents possessed many disadvantages such as stent migration, tissue hyperplasia, in-stent restenosis and are difficult to remove, which catalyzes the development of biodegradable stent (BDS). In fact, BDS are not required to be removed upon implementation and leaves no residues in tissue after complete biodegradation compared to metallic or plastic stents. In vascular system, BDS, also termed bioresorbable vascular scaffold (BVS) have also been used to treat luminal stenotic or occlusive lesions in cardiovascular system, peripheral arteries system and veins. In nonvascular system, BDS, with either bare or covered designs, was employed for the treatment of occlusion, stenosis, anastomosis, leak, fistula or perforation of digestive (esophagus, gastrointestinal, biliary, pancreatobiliary, hepatobiliary), respiratory (airway), and urinary (ureteral, urethral). However, the weak radial force, in-stent thrombosis and restenosis become main issues of BDS or BVS and restrict its further clinical application. Therefore, more intensive researches are expected on the strengthening of the radial force of BDS and development of novel drug eluting techniques on its surface to prevent thrombus or restenosis. In this review it is given an updated outline of the use of BDS to treat BLD in a minimal invasive way and explore its advantages and disadvantages for a vast range of fields ranging from cardiovascular to digestive and urinary system. Further discussion to foster the investigation and development of this approach in clinical is also provided.