Angioplasty of the coronary arteries has made significant headway in the past 20 years as a treatment for atherosclerotic
vascular disease. Though
drug-eluting stents are effective, they appear to invoke a thrombogenic response. Biodegradable
stents are a promising alternative to permanent
stents and may eventually be used to solve the lingering problem of in-
stent restenosis. Additionally, fully degradable
stents have the ability to deliver more drugs to the target site than a thin coating of
drug on metallic
stents. A variety of degradable materials have been studied for
stent design, including
polyesters, polycarbonates, bacterial-derived
polymers, and corrodible metals. The ideal biodegradable
stent would be reliably deployable under fluoroscopic guidance and situate into the target lesion with minimal endovascular
trauma. The
stent should degrade into nontoxic byproducts and invoke a minimal degree of
inflammation at the target site. Finally, the
stent itself should disappear within months (to years) without significant displacement from the deployment site. Although initial data from clinical trials have been sufficient to bring biodegradable materials into the realm of feasibility, future research is undoubtedly necessary to resolve the critical issues of
inflammation and mechanical stability.