Recent advances in cardiovascular stent for treatment of in-stent restenosis: Mechanisms and strategies

doi:10.1016/j.cjche.2020.11.025

Chinese Journal of Chemical Engineering ›› 2021, Vol. 37 ›› Issue (9): 12-29.DOI: 10.1016/j.cjche.2020.11.025

• Reviews • Previous Articles Next Articles

Recent advances in cardiovascular stent for treatment of in-stent restenosis: Mechanisms and strategies

Hang Yao^1,2, Yuwei He^2,3, Jinrong Ma², Lang Jiang¹, Jingan Li⁴, Jin Wang¹, Nan Huang¹

1. Key Laboratory of Advanced Technology for Materials of the Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China;
2. Department of Chemical Engineering, University of Washington, Seattle 98195, USA;
3. Department of Pharmaceutics, School of Pharmacy, Fudan University & Key Laboratory of Smart Drug Delivery, Ministry of Education, Shanghai 201203, China;
4. School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450000, China

Received:2020-07-06 Revised:2020-10-15 Online:2021-11-02 Published:2021-09-28
Contact: Jin Wang
Supported by:
The authors wish to acknowledge financial support from the National Key Research and Development Program of China (2017YFB0702500), Natural Science Foundation of China (NSFC Project, 81801853) and Sichuan Science and Technology Program (19GJHZ0058).

Recent advances in cardiovascular stent for treatment of in-stent restenosis: Mechanisms and strategies

Hang Yao^1,2, Yuwei He^2,3, Jinrong Ma², Lang Jiang¹, Jingan Li⁴, Jin Wang¹, Nan Huang¹

1. Key Laboratory of Advanced Technology for Materials of the Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China;
2. Department of Chemical Engineering, University of Washington, Seattle 98195, USA;
3. Department of Pharmaceutics, School of Pharmacy, Fudan University & Key Laboratory of Smart Drug Delivery, Ministry of Education, Shanghai 201203, China;
4. School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450000, China

通讯作者: Jin Wang
基金资助:
The authors wish to acknowledge financial support from the National Key Research and Development Program of China (2017YFB0702500), Natural Science Foundation of China (NSFC Project, 81801853) and Sichuan Science and Technology Program (19GJHZ0058).

Abstract

Abstract: Treatments of atherogenesis, one of the most common cardiovascular diseases (CVD), are continuously being made thanks to innovation and an increasingly in-depth knowledge of percutaneous transluminal coronary angioplasty (PTCA), the most revolutionary medical procedure used for vascular restoration. Combined with an expanding balloon, vascular stents used at stricture sites enable the long-time restoration of vascular permeability. However, complication after stenting, in-stent restenosis (ISR), hinders the advancement of vascular stents and are associated with high medical costs for patients for decades years. Thus, the development of a high biocompatibility stent with improved safety and efficiency is urgently needed. This review provides an overview of current advances and potential technologies for the modification of stents for better treatment and prevention of ISR. In particular, the mechanisms of in-stent restenosis are investigated and summarized with the aim to comprehensively understanding the pathogenesis of stent complications. Then, according to different therapeutic functions, the current stent modification strategies are reviewed, including polymeric drug eluting stents, biological friendly stents, prohealing stents, and gene stents. Finally, the review provides an outlook of the challenges in the design of stents with optimal properties. Therefore, this review is a valuable and practical guideline for the development of cardiovascular stents.

Key words: Cardiovascular stent modification, In-stent restenosis, Late stent thrombosis, Re-endothelialization, Inflammatory modulation

摘要： Treatments of atherogenesis, one of the most common cardiovascular diseases (CVD), are continuously being made thanks to innovation and an increasingly in-depth knowledge of percutaneous transluminal coronary angioplasty (PTCA), the most revolutionary medical procedure used for vascular restoration. Combined with an expanding balloon, vascular stents used at stricture sites enable the long-time restoration of vascular permeability. However, complication after stenting, in-stent restenosis (ISR), hinders the advancement of vascular stents and are associated with high medical costs for patients for decades years. Thus, the development of a high biocompatibility stent with improved safety and efficiency is urgently needed. This review provides an overview of current advances and potential technologies for the modification of stents for better treatment and prevention of ISR. In particular, the mechanisms of in-stent restenosis are investigated and summarized with the aim to comprehensively understanding the pathogenesis of stent complications. Then, according to different therapeutic functions, the current stent modification strategies are reviewed, including polymeric drug eluting stents, biological friendly stents, prohealing stents, and gene stents. Finally, the review provides an outlook of the challenges in the design of stents with optimal properties. Therefore, this review is a valuable and practical guideline for the development of cardiovascular stents.

关键词: Cardiovascular stent modification, In-stent restenosis, Late stent thrombosis, Re-endothelialization, Inflammatory modulation

Hang Yao, Yuwei He, Jinrong Ma, Lang Jiang, Jingan Li, Jin Wang, Nan Huang. Recent advances in cardiovascular stent for treatment of in-stent restenosis: Mechanisms and strategies[J]. Chinese Journal of Chemical Engineering, 2021, 37(9): 12-29.

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Recent advances in cardiovascular stent for treatment of in-stent restenosis: Mechanisms and strategies

Recent advances in cardiovascular stent for treatment of in-stent restenosis: Mechanisms and strategies

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