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REVIEW ARTICLES

Biocompatibility aspects of new stent technology

Olivier F. Bertrand, MD^{* ,1}, Rajender Sipehia, PhD, Rosaire Mongrain, PhD, Josep Rodés, MD^*, Jean-Claude Tardif, MD^*, Luc Bilodeau, MD^*, Gilles Côté, MD, FACC^* and Martial G. Bourassa, MD, FACC^*

^* Research Center, Montreal Heart Institute, McGill University, Montreal, Quebec, Canada
Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
Artificial Cells and Organs Research Centre, McGill University, Montreal, Quebec, Canada
Department of Biomedical Engineering, Montreal Heart Institute, Montreal, Quebec, Canada

Manuscript received October 9, 1997; revised manuscript received May 4, 1998, accepted May 15, 1998.

Address for correspondence: Dr. Olivier F. Bertrand, Interventional Cardiology Laboratories, Montreal Heart Institute, Belanger East, 5000, Montreal, Quebec, Canada H1T 1C8
ofbert{at}icm.umontreal.ca

Stent implantation represents a major step forward since the introduction of coronary angioplasty. As indications continue to expand, better understanding of the early and late biocompatibility issues appears critical. Persisting challenges to the use of intracoronary stents include the prevention of early thrombus formation and late neointima development. Different metals and designs have been evaluated in animal models and subsequently in patients. Polymer coatings have been proposed to improve the biocompatibility of metallic stents or to serve as matrix for drug delivery and they are currently undergoing clinical studies. The promises of a biodegradable stent have not yet been fulfilled although encouraging results have recently been reported. Continuous low dose-rate brachytherapy combining the scaffolding effect of the stent with localized radiation therapy has witnessed the development and early clinical testing of radioactive stents. The combined efforts of basic scientists and clinicians will undoubtedly contribute to the improvement of stent biocompatibility in the future.

Abbreviations and Acronyms   PEO/PBTP = polyethylenoxide/polybutylene terephtalate copolymer   PLLA = poly-l-lactic acid   PHBV = polyhydroxy-butyrate-valerate copolymer   POP = poly(organo)phosphazene

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