Medical Advancements To Look Forward To This Year #4: Bioabsorbable Stents
4. Bioabsorbable Stents
Coronary artery disease (CAD) is one of the most common cardiovascular disorders that carry a high risk of morbidity and mortality if left untreated. Patients usually present with a sudden onset of severe chest pain and possible difficulty breathing, among other symptoms. Many of these individuals suffer from a host of comorbidities, including hypertension, hyperlipidemia, COPD, and diabetes. Stable angina, comprising of chest pain on exertion that subsides on resting, eventually progresses to unstable angina in these patients due to complete closure of one or more coronary arteries in the heart, impeding blood flow.
The current standard of treatment for these patients is percutaneous coronary intervention (PCI). The procedure involves threading a catheter up through the patient’s femoral artery in the groin to the coronary artery in question in order to carry out a balloon angioplasty to expand the arterial diameter followed by potential deployment of a metallic stent that keeps the artery expanded to allow proper blood flow. However, this procedure does come with substantial risks and post-operative complications, such as the need to stay on anticoagulant drugs for prevention of blood clot formation, restenosis of the artery, stroke, and death.
Since 2011, there has been a surge of interest in bioabsorbable stents, which are made from biodegradable polymers that eventually leave the body as foreign material after they have run their course. The stent’s actions are akin to absorbable sutures used commonly in surgery. In addition, it brings a host of potential advantages, including a lower risk of inflammation, reactivity against the stent, restenosis, and a lack of issues in performing a coronary artery bypass graft (CABG) if needed on patients (which can be an issue with metallic stents). Since receiving FDA approval in 2016, these stents have been tested in clinical trials to determine their efficacy and the results have been promising. However, we still have a long way to go. Given their foreign nature, these bioabsorbable stents still carry a risk of rejection by the patients and a contraindication for patients who cannot take antiplatelets like aspirin, which is a corollary treatment to the stent placement.
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