Stent use in cardiovascular disease
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Stent Use in Cardiovascular Disease: Types, Evolution, and Clinical Impact
Role of Stents in Cardiovascular Disease Treatment
Stents are crucial devices used to treat coronary artery disease, a leading cause of death worldwide. They are inserted into narrowed arteries to keep them open, ensuring proper blood flow and reducing the risk of heart attacks and other complications. Over the years, stent technology has evolved significantly to improve patient outcomes and minimize side effects Udriște2021Weiss2022Beshchasna2020.
Evolution of Stent Technology: From Bare-Metal to Drug-Eluting and Biodegradable Stents
Bare-Metal Stents (BMS)
The earliest stents were bare-metal stents, which provided mechanical support to arteries but were associated with a high risk of restenosis (re-narrowing of the artery) Udriște2021Borhani2018Beshchasna2020.
Drug-Eluting Stents (DES)
Drug-eluting stents marked a major advancement by releasing medications that prevent tissue growth inside the stent, significantly reducing restenosis compared to BMS. Modern DES use thin struts and advanced polymers to further improve safety and effectiveness. However, concerns remain about long-term safety, such as delayed healing and risk of thrombosis, especially with first-generation DES Weiss2022Torii2019Borhani2018+1 MORE.
Bioresorbable and Biodegradable Stents
To address the limitations of permanent stents, bioresorbable and biodegradable stents have been developed. These stents gradually dissolve after the artery heals, potentially reducing long-term complications like thrombosis and restenosis. Materials used include biodegradable polymers and metals such as magnesium, iron, and zinc. While promising, these stents still face challenges in balancing mechanical strength, degradation rate, and biocompatibility Udriște2021Hu2018Shen2022+1 MORE.
Advances in Stent Design and Manufacturing
Surface Functionalization and Coatings
Recent research focuses on improving stent surfaces to enhance healing and reduce complications. Surface coatings can control drug release, improve biocompatibility, and promote endothelialization (growth of healthy vessel lining), which helps prevent thrombosis and restenosis Beshchasna2020Wang2024.
Innovative Manufacturing Techniques
Technologies like 3D printing are revolutionizing stent production, allowing for patient-specific designs and rapid prototyping. These advances enable the creation of stents with optimized mechanical properties and tailored drug delivery, supporting the move toward personalized cardiovascular care Khan2024Shen2022Zong2022.
Ongoing Challenges and Future Directions
Despite significant progress, stent-related complications such as in-stent restenosis, thrombosis, and delayed healing remain concerns. Research continues to focus on optimizing stent materials, drug release mechanisms, and surface modifications. The development of fully biodegradable stents and integration of biosensors for real-time monitoring are promising areas for future improvement Torii2019Borhani2018Hu2018+2 MORE.
Conclusion
Stents have transformed the treatment of cardiovascular disease, evolving from simple metal scaffolds to sophisticated drug-eluting and biodegradable devices. Ongoing innovations in materials, coatings, and manufacturing are aimed at further reducing complications and improving long-term outcomes for patients. As research progresses, the future of stent technology holds promise for safer, more effective, and personalized cardiovascular interventions.
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