Are Biodegradable Third Generation Drug Eluting Stents the Answer to Instent Restenosis?
Amod Amritphale *
Department of Internal Medicine, UNSOM, Las Vegas, NV, USA
Nupur Amritphale
Department of Pediatrics, Sir Ganga Ram Hospital, New Delhi, India
Chowdhury H. Ahsan
Cardiovascular Research Department of Cardiology, UNSOM; Las Vegas, NV, USA
*Author to whom correspondence should be addressed.
Abstract
The third generation biodegradable Drug Eluting Stent (DES) are being evaluated and being introduced in clinical practice. They have been DESigned to overcome limitations associated with durable polymer and a persistent metallic stent scaffold which could be related to late target lesion revascularization (TLR) and very late stent thrombosis (VLST). Although a recent pooled data analysis found that biodegradable polymer stents were superior for TLR and VLST compared with first generation Sirolimus Eluting Stent (SES), superiority has not been demonstrated against second generation Everolimus eluting stents (EES) and is yet to be conclusively proven in randomized trials. This paper reviews the key features, recent trial data, and future directions of the third generation of DES technology including stents with fully biodegradable scaffolds, stents with biodegradable polymer, and polymer free stents.
Keywords: Biodegradable, coronary, stents