New Materials New Technology Gives PCI Surgery New Possibilities II

The drug eludes the stent.

Currently, drug elution stents are generally considered a mature technique with good clinical efficacy and high safety, and can repeat clinical results data. These brackets are dominated by bare metal brackets made of stainless steel or cobalt-chromium, which, unlike bare metal brackets, are covered by drug carriers with anti-growth effects, including permanent polymers, biodegradable polymers or non-use polymers.

Currently, there are two main types of permanent polymer drug elution stents that are widely used: the fluoropolymer-based Ivemos elution stent and the zothmos hallows based on the Bi ol inx polymer, and the clinical effects of the two stents are similar.

Several EU CE-certified stents have been granted for the removal of biodegradable polymer drugs, one of which has been approved for use in the United States. Most biodegradable polymer drug elution stents have a conventional metal frame, and their metal substrates consist of polylactic acid or polylactic acid-co-ethanolic acid, which is converted into carbon dioxide and water, and the conversion process typically takes 6 weeks to 24 months, depending on the molecular weight and crystallinity of the polymer configuration. The advantage of biodegradable polymer drug elution stents is that there is no polymer residue on the support trunk and can reduce the occurrence rate of adverse events after bracket placement. However, while late follow-up results have shown that biodegradable polymer drug elution stents are more effective than first-generation polymer drug elution stents, there is no evidence that they are superior to current durable polymer drug elution stents in terms of long-term durability.

Drug-coated balloons.

Drug-coated balloon catheter technology applies the package to the surface of a conventional balloon catheter, which consists of an active drug and an apacing or excipient to prevent drug clumps and promotethe drug transfer from the spherical surface to the vascular wall.

To date, clinically successful drug-coated cyocytic angioplasty cases have been limited to coated balloons based on yew alcohol preparations, which provide favorable local tissue transport and binding capacity compared to other formulations. The challenge of coronary arterial drug-coated cyalot technology is to demonstrate the same or superior performance as the drug-removal stent, which already has excellent efficacy and safety, and studies have shown that the clinical effect of the stent is superior to angioplasty. Therefore, drug-coated cyostic angioplasty has not been widely used in coronary therapy. At present, the technology is mainly used in the field of peripheral vascular system therapy.

Bio-absorbable bracket.

Bioabsorbability brackets are made up of biodegradable materials, the most common of which are polymers, such as polylactic acid or magnesium alloys.

The Ivymos Eludican Stent (ABSORB) with a polylactic acid skeleton has been subjected to large-scale randomized trials. The results of the ABSORB II trial showed that the vascular diastolic response to nitroglycerin nitrate was not improved by angiogram measurement in 3 years after surgery compared with the conventional metal ivemole elution stent. However, the anti-narrowing effect of the replacement endpoint assessment through the late tube cavity loss is relatively good.

The ABSORB III study is by far the largest bioabsorbable stent randomized trial. The study found that the target lesions failure rate of 1 year after the bioabsorbable stent was not significantly changed compared with the ivmosh stent, but the incidence of stent thrombosis was higher within 1 year, and in 2 years after surgery, the incidence of bioabsorbable stent target lesions failure and target vascular myocardial infarction was higher, and the effect on stent thrombosis was not statistically significant. However, several studies have also shown that bioabsorbable stents have a higher risk of thrombosis than metal drug elution stents, and that the potential benefits of bioabsorbable stent technology may only be apparent after being fully bioabsorbed (THE ABSORPTION TIME OF THE ABSORBent stent is approximately 3 years). Currently, bioabsorbable stents are in the stage of large-scale clinical trials and have a follow-up period of more than 5 years. This new technology has potential advantages, but it also needs to be further optimized and addressed.