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Evolution of covered stents in the contemporary era: clinical application,materials and manufacturing strategies using nanotechnology
Authors:Yasmin Farhatnia  Aaron Tan  Aamir Motiwala  Brian G. Cousins  Alexander M. Seifalian
Affiliation:1. Centre for Nanotechnology and Regenerative Medicine, UCL Division of Surgery & Interventional Science, University College London, London, United Kingdom;2. UCL Medical School, University College London, London, United Kingdom;3. Royal Free London NHS Foundation Trust, London, United Kingdom
Abstract:Endovascular stents have revolutionised the field of interventional cardiology. Despite their excellent clinical outcome complications associated with percutaneous stent implantation following the procedure have remained a major drawback in their widespread use. To overcome such limitations, a number of novel endovascular stents have emerged including a covered stent wrapped in a thin membrane sleeve. As well as prevention of complications associated with stenting, covered stents owing to their physical barrier are used as the treatment option of choice for trauma devices during emergency situations and to treat a number of pathological disease states. The aim of this review is to provide the reader with an overall objective outlook in the use of covered stents as a treatment option in a number of vascular complications and addresses their design and materials used in the manufacturing process. In addition, new strategies are highlighted and future prospects with the emergence of novel smart alloys for 3D scaffolds and the use of nanotechnology in the development of nanocomposite materials.
Keywords:ADP, Adenosine diphosphate   ATRP, Atom transfer radical polymerisation   BMS, Bare metal stent(s)   BSE, Bovine spongiform encephalopathy   CABG, Coronary artery bypass graft surgery   CAF, Coronary artery fistula   CCF, Carotid cavernous fistulae   CoA, Coarctation of the aorta   CoCr, Cobalt chromium   CP, Cheatham-platinum   CPPs, Caseinophosphopeptides   CVD, Chemical vapour deposition   DES, Drug eluting stent(s)   ECM, Extracellular matrix   EPCs, Endothelial progenitor cells   eNOS, Endothelial nitric oxide synthase   HA, Hyaluronic acid   ICA, Internal carotid artery   IH, Intimal hyperplasia   ISR, In-stent restenosis   LAST, Late stent thrombosis   MACE, Major adverse cardiac events   MI, Myocardial infarctions   PEG, Poly (ethylene glycol)   PEO, Polyethylene oxide   PET, Polyethylene terephthalate   PLD, Pulsed laser deposition   PLGA, Poly (lactic-co-glycolic acid)   POSS, Polyhedral oligomeric silsesquioxane   PTA, Percutaneous transluminal angioplasty   PtCr, Platinum chromium   PTFE, Polytetrafluoroethylene   PU, Polyurethane   RGD, Arginine&ndash  glycine&ndash  aspartic acid   SC, Collagen film from salmon   SMCs, Smooth muscle cells   SNP, Sodium nitroprusside   SVGs, Saphenous vein grafts   TF, Tissue factor   VEGFR, Vascular endothelial growth factor receptor   VLST, Very late stage thrombosis   vSMC, Vascular smooth muscle cells   vWF, Von Willebrand factor   WBCs, White blood cells
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