Pharmapolymers in the 21st century: Synthetic polymers in drug delivery applications

There is a growing need for dedicated endovascular devices to treat pathologies affecting the venous system. However, because of a lack of research into venous diseases and treatments, the optimal design, material, and mechanical properties of venous stents remain unknown. Development of the ideal venous stent should be based on a thorough understanding of the underlying venous pathology. There are multiple venous diseases that differ from each other depending on their location (iliocaval, superior vena cava), mechanism (thrombotic versus nonthrombotic lesions), and chronicity. Thus, it is likely that stent material, design, and features should differ according to each underlying disease. From a mechanical point of view, the success of a venous stent hinges on its ability to resist crushing (which requires high global and local radial rigidity) and to match with the compliant implant environment (which requires high flexibility). Device oversizing, textile coverage, and drug coating are additional features that should be considered in the context of venous diseases rather than directly translated from the arterial world. This review examines the unique forces affecting venous stents, the problems with using arterial devices to treat venous pathologies, preliminary results of a study comparing crush resistance of commercially available laser-cut stents with a novel braided stent design, and its applicability to venous interventions.

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Endovascular Treatment for Venous Diseases: Where are the Venous Stents?

Restenosis is one of the main adverse effects of the treatment of atherosclerosis through balloon angioplasty or stenting. During the intervention, the arterial wall is overstretched, causing a cas...

A homogenized constrained mixture model of restenosis and vascular remodelling after balloon angioplasty.

WIRION EPS Filter with Jetstream Atherectomy of Femoropopliteal Arterial Disease: A Single Center Experience.

Objectives This study aims to evaluate the effects of dihydroartemisinin (DHA) on the balloon injury-induced neointimal formation in rats and to investigate the underlying mechanism. Methods The balloon-induced carotid artery injury model was established in male Sprague-Dawley rats, immediately after which the DHA solution was injected into the tail vein of rats. In in vitro assays, primary rat vascular smooth muscle cells (VSMCs) were pretreated with DHA and then coincubated with LPS. Results DHA ameliorated the induced neointimal formation and fibrosis but enhanced apoptosis in rat carotid artery after balloon injury. Furthermore, DHA suppressed migration and enhanced apoptosis of the lipopolysaccharide (LPS)-treated primary VSMCs in vitro. Moreover, in both the balloon injury-induced rat sera and the LPS-treated VSMCs, DHA significantly inhibited proinflammatory cytokines, including interleukin-1β, tumor necrosis factor-ɑ, and matrix metalloproteinase-1. Importantly, DHA significantly decreased the balloon injury-increased expression of nuclear factor kappa B (NF-κB) subunit NF-κB p65 expression, and increased the balloon injury-reduced expression of inhibitor of NF-κB-alpha, indicating the inhibition of the IκB/NF-κB pathway. Conclusion DHA significantly inhibited neointimal formation in balloon-induced rat carotid artery injury and the mechanism may be related to the inhibition of IκB/NF-κB signaling, which alleviates the inflammatory response.

Dihydroartemisinin ameliorates balloon injury-induced neointimal formation in rats.

Endovascular intervention is a mainstay treatment of peripheral artery disease (PAD) in addition to aggressive risk factor modification and exercise programs in patients with favorable anatomy or in those who are considered too high risk for surgical intervention. Treatment with percutaneous transluminal angioplasty (PTA) and bare metal stents (BMS) has been limited by high rates of in-stent restenosis (ISR) requiring repeat revascularization. Drug-eluting stents (DES), developed and designed to reduce ISR, offer a promising solution to the current challenges in endovascular management of PAD. Several randomized clinical trials have shown improved short- and mid-term outcomes with DES as compared with both PTA and BMS. Herein we provide an up-to-date review of the current literature on DES use in PAD.

Drug-Eluting Stents for Treatment of Peripheral Artery Disease.

TCT-60 Stent Versus Non-Stent Strategies For Endovascular Treatment of Femoropopliteal Peripheral Artery Disease: Insights From the XLPAD Registry

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Drug-Eluting Stents for Treatment of Peripheral Artery Disease.

TCT-60 Stent Versus Non-Stent Strategies For Endovascular Treatment of Femoropopliteal Peripheral Artery Disease: Insights From the XLPAD Registry