27 January 2014

Arterial stents, soluble without sediment

Researchers at the University of Vienna, working under the guidance of Dr. Johannes Lammer, have developed a drug-coated biodegradable frame for insertion into the lumen of the arteries of the legs of patients with peripheral artery disease (peripheral obliterating endarteritis).

In this disease, the blood circulation of the legs is disrupted due to atherosclerotic plaques blocking the arteries. As a result, a person experiences severe pain when walking. In severe cases, the disease can lead to trophic ulcers and gangrene of the lower extremities. Traditionally, metal wire spiral stents are inserted into blocked arteries with the help of a catheter to prevent the collapse of the vascular lumen and release anti–inflammatory drugs.

The main problem associated with the use of stents is the irritation and inflammation of the inner lining of the vessels caused by them, which often leads to restenosis – repeated narrowing of the lumen. Moreover, the arteries of the lower extremities, unlike the coronary arteries, are subjected to significant loads during daily activity, which can lead to stent breakage.

The new device is, in fact, similar to a stent. The main difference is that, unlike the stent preserved in the vessel, the frame made of polylactide (polylactic acid) gradually dissolves.

As part of a clinical study devoted to the study of the possibility of use and safety, a biodegradable frame was implanted in 35 patients with single blockages of the arteries of the legs. Prior to the procedure, 57% of the study participants complained of severe pain in their legs while walking. Within 6 months after implantation of the device, this indicator decreased to 0. The number of patients complaining of moderate pain decreased from 34% to 9%.

However, the researchers note that the results are preliminary and they have yet to answer a number of questions. To do this, they plan to monitor the condition of patients for three years.

According to Lammer, it is necessary to conduct a clinical study, the purpose of which will be to compare the effectiveness and safety of standard stents and biodegradable frames. It is also necessary to make sure that the use of the latter really excludes the possibility of arterial restenosis and whether it is appropriate in the most severe cases of peripheral artery disease.

Experts also warn that quitting smoking and controlling high blood pressure, as well as glucose and cholesterol levels in the blood are preventive measures that will allow many to avoid the need to use stents.

The results of the study were presented at the International Symposium on Endovascular Therapy held last week in Miami.

Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru based on Medical Xpress materials:
Dissolving 'scaffolds' could help treat leg artery disease.


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