scholarly journals A viewpoint on material and design considerations for oesophageal stents with extended lifetime

2022 ◽  
Author(s):  
Caitlin E. Jackson ◽  
Liam S. J. Johnson ◽  
Dominic A. Williams ◽  
Hans-Ulrich Laasch ◽  
Derek W. Edwards ◽  
...  
Keyword(s):  
Patient Survival ◽  
Drug Eluting Stent ◽  
Material Surface ◽  
Device Performance ◽  
Stent Design ◽  
Novel Treatments ◽  
Construction Methods ◽  
Drug Eluting

AbstractOesophageal stents are meshed tubular implants designed to maintain patency of the oesophageal lumen and attenuate the symptoms of oesophageal cancer. Oesophageal cancers account for one in twenty cancer diagnoses and can lead to dysphasia, malnutrition and the diminishment of patient quality of life (QOL). Self-expanding oesophageal stents are the most common approach to attenuate these symptoms. Recent advances in oncological therapy have enabled patient survival beyond the lifetime of current devices. This introduces new complications for palliation, driving the need for innovation in stent design. This review identifies the factors responsible for stent failure. It explores the challenges of enhancing the longevity of stent therapies and outlines solutions to improving clinical outcomes. Discussions focus on the role of stent materials, construction methods, and coatings upon device performance. We found three key stent enhancement strategies currently used; material surface treatments, anti-migratory modifications, and biodegradable skeletons. Furthermore, radioactive and drug eluting stent designs were identified as emerging novel treatments. In conclusion, the review offers an overview of remaining key challenges in oesophageal stent design and potential solutions. It is clear that further research is needed to improve the clinical outcome of stents and patient QOL.

scholarly journals Neoatherosclerosis after Drug-Eluting Stent Implantation: Roles and Mechanisms

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Yuanyuan Cui ◽  
Yue Liu ◽  
Fuhai Zhao ◽  
Dazhuo Shi ◽  
Keji Chen
Keyword(s):  
First Generation ◽  
Critical Role ◽  
Late Complications ◽  
Drug Eluting Stent ◽  
Late Stent Thrombosis ◽  
Fibrous Cap ◽  
Close Relationship ◽  
Drug Eluting ◽  
Improve Clinical Outcome

In-stent neoatherosclerosis (NA), characterized by a relatively thin fibrous cap and large volume of yellow-lipid accumulation after drug-eluting stents (DES) implantation, has attracted much attention owing to its close relationship with late complications, such as revascularization and late stent thrombosis (ST). Accumulating evidence has demonstrated that more than one-third of patients with first-generation DES present with NA. Even in the advent of second-generation DES, NA still occurs. It is indicated that endothelial dysfunction induced by DES plays a critical role in neoatherosclerotic development. Upregulation of reactive oxygen species (ROS) induced by DES implantation significantly affects endothelial cells healing and functioning, therefore rendering NA formation. In light of the role of ROS in suppression of endothelial healing, combining antioxidant therapies with stenting technology may facilitate reestablishing a functioning endothelium to improve clinical outcome for patients with stenting.

scholarly journals TCT-478 Effect of different drug-eluting stent design on in-stent restenosis and stent thrombosis

2013 ◽  
Vol 62 (18) ◽  
pp. B146
Author(s):  
Oskar Angerås ◽  
Per Albertsson ◽  
Christian Dworeck ◽  
Inger Haraldsson ◽  
Dan Ioanes ◽  
...  
Keyword(s):  
Stent Thrombosis ◽  
Drug Eluting Stent ◽  
Stent Design ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

scholarly journals Essential role of polymer-coating in the pathogenesis of coronary hyperconstricting responses after drug-eluting stent implantation in pigs in vivo

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P1234-P1234 ◽  
Author(s):  
K. Nishimiya ◽  
Y. Matsumoto ◽  
J. Takahashi ◽  
T. Shindo ◽  
K. Hanawa ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Polymer Coating ◽  
Essential Role ◽  
Drug Eluting Stent ◽  
Drug Eluting

scholarly journals Stent Thrombosis: Incidence, Predictors and New Technologies

Thrombosis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Gill Louise Buchanan ◽  
Sandeep Basavarajaiah ◽  
Alaide Chieffo
Keyword(s):  
Stent Thrombosis ◽  
New Technologies ◽  
Platelet Reactivity ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Very Late Stent Thrombosis ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
The Individual

Some concerns have been raised regarding the risk of late and very late stent thrombosis (ST) following drug-eluting stent implantation. Despite remaining an uncommon complication of percutaneous coronary intervention, when ST occurs, it can be catastrophic to the individual, commonly presenting as acute ST elevation myocardial infarction or sudden cardiac death. The incidence and predictors of ST have been reported in the literature and the role of dual antiplatelet therapies in the avoidance of such a complication remains vital. Ongoing studies are assessing the role of these therapies including platelet reactivity testing, genetic testing and optimum duration of therapy. In addition, newer polymer-free and bioabsorbable stents are under investigation in the quest to potentially minimise the risk of ST.

The Role of Drug-coated Balloons in Infrapopliteal Intervention

2012 ◽  
Vol 9 (2) ◽  
pp. 112-114
Author(s):  
Gary M Ansel ◽  
Peter A Schneider
Keyword(s):  
Endovascular Therapy ◽  
Metal Stents ◽  
Below The Knee ◽  
Straight Line ◽  
Improved Outcomes ◽  
Line Flow ◽  
Drug Eluting ◽  
One Year

The goal of infrapopliteal endovascular therapy is the re-establishment of straight-line flow to the foot with adequate perfusion of tissue. This treatment should be the first method in properly selected patients to relieve ischemic rest pain, heal ulcers and prevent limb loss, improving quality of life. Percutaneous angioplasty (PTA) continues to be the cornerstone of infrapopliteal therapy. Metal stents are reserved for suboptimal PTA. Although data are accumulating that may eventually guide the use of alternative devices such as lasers, excisional, and rotational atherectomy, drug-eluting stents or drug-coated balloons, we currently lack adequate evidence demonstrating improved outcomes. Endovascular therapy has expanded to include patients with severe co-morbidities such as renal failure and complex occlusive disease. Despite advances in below-the-knee (BTK) angioplasty balloons and a focus on angioplasty technique, current PTA results demonstrate one-year restenosis rates up to 80 %, depending on lesion complexity. Drug-coated balloons have demonstrated superior patency in the superficial femoral artery and it is yet to be determined if this technology can achieve improved patency and the clinical outcomes in the infrapopliteal region.

Sign in / Sign up

Export Citation Format

Share Document