Use of Biomaterials and Biomolecules for the Prevention of Restenosis

Abstract

Coronary balloon angioplasty and coronary stenting are the procedures used in healing coronary artery disease. However, injury of arteries during angioplasty and stenting causes cell stimulations in tissue. Cell movement and thrombosis lead to renarrowing of widened vessel called restenosis. Several new types of carriers and technology have been developed to suppress and/or prevent restenosis via prevention of migration/proliferation of smooth muscle cells (SMCs). The conventional ap‐ proaches are not fully effective for inhibiting restenosis. In order to eliminate such problems, stent-based delivery methods are developed to replace traditional vascular approaches. A series of materials have been improved for controlled delivery/release of genes, miRNAs, peptide structures, siRNAs, miRNAs, and antisense molecules to the target tissue. Agents to be delivered are either attached to the materials or entrapped in polymeric structure. In particular, biodegradable polymers have held great interests in drug delivery for targeting or prolonging implantable drug release. This chapter summarizes the molecular mechanisms of in-stent restenosis, the role of SMCs and endothelial cells in restenosis, and recent researches about the polymeric materials featured in drug/gene carrier systems, nanovehicles, and stent coating materials to prevent restenosis.