Week 10: stents

Question 1

what happens when someone has CAD (coronary artery disease)?

Answer 1

the lumen become insufficiently narrowed restricting blood from flowing

Question 2

how can CAD be treated?

Answer 2

• Percutaneous transluminal coronary angioplasty (PTCA) with bare-metal stent (BMS)
placement has been used in clinical practice for treating obstructive CAD

Question 3

what is the role of a BMS?

Answer 3

ACTSAS A MECHANICAL SCAFFOLD

Question 4

what drugs should a patients be on after a stent has been inserted?

Answer 4

-long term antiplatelet therefore aspirin and clopidogrel for 12 months clopidergol will be reviewed

Question 5

what are the problems with BMS?

Answer 5

patients ends up with thromobosis or in-stent restenosis

Question 6

what is a drug eluting stent?

Answer 6

• a stent that slowly releases a drug

- BMS platform which has been coated in a formulation of drugs and carrier materials normally immunosuppresant drug

Question 7

what drugs are used in DES and why?

Answer 7

• Immunosuppressant drug: inhibit the cytokine- and
growth-factor-mediated cell proliferation
• Paclitaxel: inhibit smooth muscle cell proliferation
through stabilisation of microtubules

Question 8

what is the stent platform made from?

Answer 8

- conventionally
stainless steel, metallic alloys
(nickel-titanium and cobaltchromium) and biodegradable
polymers are used recently
- Stent coating for controlled
release of drug: polymers used
including durable (biostable but
non-biodegradable) polymers,
biodegradable polymers, and
biological polymers.
- Drug release from stents significant
affected by the coating polymer
used

Question 9

what are some future developments for DE stents?

Answer 9

• biomatrix flex pla/plla polymerstent coated with a degradable polymer. coating and drug release disappears at same rate so ends up are BMS
• stents that are made from biodegradable stent completely no metal involved and has a gold marker to see it inside eventually it will disappear but the artery will be strong enough to stay open
• bio freedom using a polymer free stent and just drug therfore drug release is faster
• yukon stents surface is coated with drug and has wells where the drug is also kept in as well as surface drug

Question 10

WHAT IS A DRUG COATED BALLOON?

Answer 10

the balloon is coated with drug and can artifcally open up the artery.
-Nonstent-based local drug delivery
during PCI offers potential for sustained
antirestenotic efficacy without the
limitations of permanent vascular
implants