ĭetermining the direct relationship between stent materials and possible adverse effects is very difficult and has still not been done. The presence of metal ions due to the erosion and degradation of metals and their alloys utilized in some stents as a metal base. The prospective success of DES for long-term clinical applications depends on the following areas: ĭespite the supreme advantages of DESs over BMSs, in-stent restenosis (ISR) and long-term safety remain ongoing concerns in the clinical application of DESs. Moreover, drugs for DES should have a selective mode of action targeted at preventing in-stent restenosis, including (1) the capability of inhibiting the platelet aggregation, inflammation, smooth muscle cell (SMC) proliferation, and migration and (2) promoting appropriate healing and fast endothelialization. It is assumed that the drug release process will be slow and programmed for controlled delivery. The first DES released only small amount of the drug and only in one portion, which, in most cases, proved insufficient. However, it soon turned out that there are some limitations in delivering the sufficient amount of drugs in a suitable time frame by DES. Releasing pharmaceutical agents from the stent surface was promising progress in the realm of cardiovascular stents. The first bare-metal stents (BMS) were quickly supplemented with modern systems supplemented by drug-eluting coatings. The most commonly used categorization is the division into classic metal stents (BMS-bare metal stents) and drug-eluting stents (DES-drug-eluting stents or DCS-drug-coated stents). There are many types of endovascular prostheses and many criteria for their classification. Later advancements in this field included the first human implantation of a self-expanding stent in 1986, and further in 1987, the first human implantation of a balloon-expandable stent. In turn, balloon angioplasty (BA), first introduced in 1977 by Grüntzig, was a further step in the development of treatment techniques for coronary heart diseases. The idea of a cardiovascular stent has revolutionized coronary disease-related therapies. One of the most commonly used treatments for coronary heart disease is percutaneous transluminal coronary angioplasty (PTCA) with stents and balloon catheters. Meeting all of the CDDS objectives (appropriate drug concentration, delivery time, and delivery target place) is a considerable challenge.įor decades, cardiovascular diseases have been at the forefront of death statistics. Medicines that can be used for appropriate therapy. Information was also collected on the various methods of producing drug release coatings and their effectiveness in releasing the active substance. Special attention was paid to the polymeric biodegradable materials used in the production of the above-mentioned devices. This report reviews the works related to achievements in construction designs and materials, as well as preparation technologies, of DES and DEB. This paper presents milestones in the development of DES and DEB, which are a significant option in the treatment of coronary artery diseases. These advances result in the development of both successive models of drug-eluting stents (DES) and drug-eluting balloons (DEB). Modern technology is continually striving to improve the results of previous generations of stents and balloon catheters by refining their design, structure, and constituent materials.
Balloon catheters are also successfully used to manage tear ducts, paranasal sinuses, or salivary glands disorders. In recent years, stents and balloon catheters have reached a significant position in the treatment of this condition. One such disease is an obstructive arterial disease affecting millions of people around the world. Heart diseases are particularly important in this aspect. In the treatment of many diseases, it is crucial to control the dosing of a drug for a long time and thus maintain its optimal concentration in the tissue. Controlled drug delivery is a matter of interest to numerous scientists from various domains, as well as an essential issue for society as a whole.
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