Biodegradable Cardiovascular Stents Research Articles

Electroformed iron as new biomaterial for degradable stents: Development process and structure–properties relationship

An electroforming technique was developed for fabricating iron foils targeted for application as biodegradable cardiovascular stent material. The microstructure, mechanical properties and corrosion of electroformed iron (E-Fe) foils were evaluated and compared with those of pure iron made by casting and thermomechanical treatment (CTT-Fe), with 316L stainless steel (316L SS) and with other candidate metallic materials for biodegradable stents. Electron backscattered diffraction revealed an average grain size of 4 μm for E-Fe, resulting in a high yield (360 MPa) and ultimate tensile strength (423 MPa) being superior to those of other metallic biodegradable stent materials. Annealing at 550 °C was found to improve the ductility of the E-Fe from 8% to 18%. The corrosion rate of E-Fe in Hanks’ solution, measured by potentiodynamic polarization, was higher than that of CTT-Fe, which had been found to have a slow in vivo degradation. The results showed that E-Fe possesses fine-grain microstructure, suitable mechanical properties and moderate corrosion rate as a degradable stent material.

Overview of the 2007 Food and Drug Administration Circulatory System Devices Panel Meeting on the Endeavor Zotarolimus-Eluting Coronary Stent

Initial trials comparing stenting with balloon angioplasty demonstrated improved angiographic and clinical outcomes with the former.1–3 The main clinical problem with bare metal stents (BMS) became the development of in-stent restenosis.4–6 Early data suggested that drug-eluting stents (DES) could mitigate, if not abolish, this problem.7–9 Since the approval of DES, these devices have become the predominant stents used in percutaneous coronary interventions, regardless of indication. As of September 2007, the Cypher sirolimus-eluting stent (SES) (Cordis Johnson & Johnson, Miami Lakes, Fla) had been deployed in >3 million patients worldwide,10 and the millionth Taxus paclitaxel-eluting stent (PES) (Boston Scientific, Natick, Mass) was implanted as of January 2005.11 Over the past 2 years, numerous reports of very late stent thrombosis (ST) with first-generation DES have surfaced. This highly morbid complication and data suggesting that death and myocardial infarction (MI) may be more common with DES12,13 have altered the focus of trials and registries working to determine optimal DES use. There is a hope that second-generation DES will be less prone to ST as a result of differences in drug, stent design, and polymer. Medtronic, Inc (Minneapolis, Minn) presented safety and efficacy data to a public meeting of the US Food and Drug Administration (FDA) Circulatory System Devices Panel (CSDP) in October 2007 on its Endeavor zotarolimus-eluting stent (ZES), seeking approval for the indication of treating de novo native coronary lesions ≤27 mm with reference vessel diameters of 2.5 to 3.5 mm. The FDA asked the CSDP to determine whether the data presented demonstrated a reasonable level of safety and effectiveness, with clinical benefits clearly outweighing short- and long-term risks of ZES use. Important efficacy end points included ischemia-driven target lesion revascularization (TLR) or target vessel revascularization (TVR); safety end points included death, MI, and ST. The …

Polymers, Drug Release, and Drug‐Eluting Stents

Implantable biomaterials mainly serve as physical support devices, carriers for bioactive molecules and guidance for tissue growth. For any application within or outside the cardiovascular area, biomaterials are subject to an extended set of requirements in order to establish safe application. These requirements mainly include acceptable biocompatibility and, if the material is to be degraded within the body, safe degradation characteristics. During degradation, biocompatible polymers are broken down into molecules that are metabolized and removed from the body via normal metabolic pathways. Major applications of these polymers include targeted drug delivery systems, resorbable sutures and orthopedic fixation devices. In the cardiovascular area they include biodegradable cardiovascular stents and drug-eluting stent (DES) coatings. This review focuses on general aspects of local drug delivery by implantable polymeric devices, with special emphasis on drug-eluting stents.