Controlled Slow-Release Drug-Eluting Stents for the Prevention of Coronary Restenosis: Recent Progress and Future Prospects.

Abstract

Drug-eluting stents (DES) have become more widely used by cardiologists than bare metal stents (BMS) because of their better ability to control restenosis. However, recognized negative events, particularly including delayed or incomplete endothelialization and late stent thrombosis, have caused concerns over the long-term safety of DES. Although stent-based drug delivery can facilitate a drug's release directly to the restenosis site, a burst of drug release can seriously affect the pharmacological action and is a major factor accounting for adverse effects. Therefore, the drug release rate has become an important criterion in evaluating DES. The factors affecting the drug release rate include the drug carrier, drug, coating methods, drug storage, elution direction, coating thickness, pore size in the coating, release conditions (release medium, pH value, temperature), and hemodynamics after the stent implantation. A better understanding of how these factors influence drug release is particularly important for the reasonable use of efficient control strategies for drug release. This review summarizes the factors influencing the drug release from DES and presents strategies for enhancing the control of the drug's release, including the stent design, the application of absorbable stents, the development of new polymers, and the application of nanocarriers and improvements in the coating technology. Therefore, this paper provides a reference for the preparation of novel controlled slow-release DES.

• Authors: Tingzhang Hu, Jiali Yang, Kun Cui, Qiong Rao, Tieying Yin, Lili Tan, Yuan Zhang, Zhenggong Li, Guixue Wang
• Journal: ACS applied materials & interfaces (ACS Appl Mater Interfaces) Vol. 7 Issue 22 Pg. 11695-712 (Jun 10 2015) ISSN: 1944-8252 [Electronic] United States
• PMID: 26011753 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Sirolimus

Topics

• Coronary Restenosis (drug therapy, prevention & control)
• Drug Delivery Systems (adverse effects)
• Drug-Eluting Stents
• Humans
• Prosthesis Design
• Sirolimus (therapeutic use)