Microfabrication and nanotechnology in stent design.
Microfabrication and nanotechnology in stent design.
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DOI：
10.1002/wnan.123
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发表时间：
2011-05
影响因子：
8.6
通讯作者：
Chaikof, Elliot L.
中科院分区：
文献类型：
--
作者：
Martinez, Adam W.;Chaikof, Elliot L.
血管内支架于20世纪80年代首次引入，作为初次血管成形术的辅助手段，用于管理早期并发症，包括动脉夹层，或治疗由于动脉粥样硬化病变的早期弹性回缩导致的技术结局不充分。尽管支架植入术具有有益效果，但持续的高再狭窄率促使设计药物洗脱支架以输送药物，从而限制血管壁内的增殖和其他炎症反应，这些反应有助于再狭窄病变的发展。这些策略已经显著降低了再狭窄的发生率，但挑战仍然存在，包括血管壁损伤部位的内皮修复不完全，这可能与血栓形成的晚期风险相关。血管壁愈合失败主要归因于使用聚合物支架涂层，但不能排除洗脱药物和支架的其他材料特性或设计特征的影响。支架微制造的改进以及替代材料的引入可能有助于解决抑制支架性能的限制。本文综述了新型微加工工艺的应用和新纳米技术的发展，这些技术在消除当前支架平台的现有缺点方面具有重要的前景。
Intravascular stents were first introduced in the 1980s as an adjunct to primary angioplasty for management of early complications, including arterial dissection, or treatment of an inadequate technical outcome due to early elastic recoil of the atherosclerotic lesion. Despite the beneficial effects of stenting, persistent high rates of restenosis motivated the design of drug eluting stents for delivery of agents to limit the proliferative and other inflammatory responses within the vascular wall that contribute to the development of a restenotic lesion. These strategies have yielded a significant reduction in the incidence of restenosis, but challenges remain, including incomplete repair of the endothelium at the site of vascular wall injury that may be associated with a late risk of thrombosis. A failure of vessel wall healing has been attributed to primarily to the use of polymeric stent coatings, but the effects of the eluted drug and other material properties or design features of the stent cannot be excluded. Improvements in stent microfabrication, as well as the introduction of alternative materials may help to address those limitations that inhibit stent performance. This review describes the application of novel microfabrication processes and the evolution of new nanotechnologies that hold significant promise in eliminating existing shortcomings of current stent platforms.
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