Implantation of cardiovascular stents is an important therapeutic method to treat coronary artery diseases. Bare-metal and drug-eluting stents show promising clinical outcomes, however, their permanent presence may create complications. In recent years, numerous preclinical and clinical trials have evaluated the properties of bioresorbable stents, including polymer and magnesium-based stents. Three-dimensional (3D) printed-shape-memory polymeric materials enable the self-deployment of stents and provide a novel approach for individualized treatment. Novel bioresorbable metallic stents such as iron- and zinc-based stents have also been investigated and refined. However, the development of novel bioresorbable stents accompanied by clinical translation remains time-consuming and challenging. This review comprehensively summarizes the development of bioresorbable stents based on their preclinical/clinical trials and highlights translational research as well as novel technologies for stents (e.g., bioresorbable electronic stents integrated with biosensors). These findings are expected to inspire the design of novel stents and optimization approaches to improve the efficacy of treatments for cardiovascular diseases.
Keywords: AMS, absorbable metal stent; Ag+, silver ions; Ag, silver; Au, gold; BDMS, biodegradable metallic stent; BDPS, biodegradable polymeric stent; BMS, bare-metal stent; BNL, base neo-intimal length; BRS, bioresorbable stent; Bioresorbable stents; CADs, coronary artery diseases; CS, chitosan; Cardiovascular scaffolds; Cl, chloride; Cl−, chloride ions; Cu, copper; DAPT, dual anti-platelet therapy; DES, drug-eluting stent; DREAMS, drug-eluting absorbable metal scaffold; EC, endothelial cell; ECAP, equal-channel angular pressure; EDM, energy dispersive spectroscopy; EEM, external elastic membrane; EL, elongation to fracture; Fe, iron; Fe2+, ferrous ions; Fe–O, iron oxide; GO, graphene oxide; H+, hydrogen ions; HA, hyaluronic acid; HUVECs, human umbilical vein endothelial cells; ISR, in-stent restenosis; IVUS, intravascular ultrasonography; In-stent restenosis; JDBM, JiaoDa BioMg; LDH, layered double-hydroxide; LLL, late lumen loss; LOI, lumen occlusion index; LST, late stent thrombosis; MACE, major adverse cardiac event; MAO, micro-arc oxidation; MPS, metal-polymer composite stent; MRI, magnetic resonance imaging; Mg, magnesium; Mg2+, magnesium ions; MgF2, magnesium fluoride; MgO, magnesium oxide; Mn, manganese; N, nitrogen; NA, neo-intimal area; OCT, optical coherence tomography; OH−, hydroxyl radicals; P, phosphorus; PCI, percutaneous coronary intervention; PCL, polycaprolactone; PDA, polydopamine; PDLLA, poly-D,L-lactic acid; PGDA, poly(glycerol-dodecanoate) acrylate; PIIID, plasma immersion ion implantation and deposition; PLA, polylactic acid; PLGA, poly-lactic-co-glycolide; PLLA, poly-L-lactide acid; PM, powder metallurgy; PTA, percutaneous transluminal angioplasty; Pd, palladium; Pt, platinum; SEM, scanning electron microscopy; SES, sirolimus-eluting stent; SMMs, shape-memory materials; SMPs, shape-memory polymers; ST, stent thrombosis; STEMI, ST-segment-elevation myocardial infarction; Stent optimization; TLF, target lesion failure; TLR, target lesion revascularization; Ta, tantalum; Tg, glass transition temperature; TiO2, titanium dioxide; Translational research; UTS, ultimate tensile strength; VGs, vein grafts; VSMCs, vascular smooth muscle cells; WLT, wire lumen thickness; YS, yield strength; Zn, zinc; Zn2+, zinc ions; micro-CT, micro-computerized tomography.
© 2022 The Authors.