DEVELOPMENT OF BIODEGRADABLE NANOFIBROUS DRUG-ELUTING STENTS: CHALLENGES AND OPPORTUNITIES
Sukhwinder Bhullar, Ph.D., Bursa Technical University, Bursa, Turkey and University of Victoria,
Victoria, BC, Canada
Drug-eluting stents are implanted for opening up narrowed or blocked arteries to restore blood flow. Coronary heart disease and acute myocardial infarction are often treated by catheterization and stenting prior to the open-heart bypass surgery. Surgical stenting opens up arteries blocked with plaque, esophageal cancer, airways blocked due to lung cancer, and weakening of the vessel wall. Relatively less hospital cost, low risk of stenting, and quick patient recovery are well recognised, as opposed to the higher risk and prolonged rehabilitation after open-heart surgery. Several varieties of stents have been developed and are available for clinical use. The Global Cardiovascular Implants Market is poised to grow around 4.5% over the next decade. Currently, the US market share for coronary stent devices is nearly 40%, while European share is around 37%. Drug-eluting stents not only reduce early and delayed complications with stenting, but also restenosis rate by 80%. However, there are challenges to minimise the potential risks of stenting: namely restenosis of arteries due to in-stent thrombosis, growth of scar tissue caused by in-stent-restenosis, migration of stent due to insufficient radial stretch, inflexibility and mechanical mismatches between stented and non-stented vessels, and shortening of in-stent length. To overcome these difficulties, development of biodegradable nanofibrous drug-eluting stents is warranted to enhance the long-term safety and mechanical effectiveness of stents. This presentation will focus on the fabrication of nanofibrous stents with targeted drug delivery system. Hopefully, biodegradable nanofibrous drug-eluting stents would overcome the mechanical challenges as well as early and delayed complications of stenting.