Mechanical properties and performances of contemporary drug-eluting stent: focus on the metallic backbone

ABSTRACT

Introduction: Drug-eluting stents (DES) are still the standard of care in percutaneous coronary intervention (PCI) since the fall of bioresorbable scaffolds with respect to safety. The unbeatable advantage of a metallic stent when compared with a scaffold is a stronger mechanical property and more sustainable vascular support. Recent development of contemporary metallic stent has focused on the reduction of strut thickness. However, there will always be a trade-off between improvement in deliverability, flexibility, and radial strength.

Areas covered: This review aims to discuss the designs of metallic stent platform and mechanical properties as well as mechanical performance of contemporary DES from bench studies and clinical trials.

Expert opinion: Mechanical properties of stents affect short- and long-term clinical outcomes. Ultrathin-strut DES have become popular and clinical trials have shown impressive results. Thinner struts may improve device flexibility and deliverability but the radial strength and longitudinal integrity might have been compromised as well. Ultrathin-strut cobalt chromium or platinum chromium DES will become standard of care in PCI practice in the near future. Information on the stent design, stent material and mechanical properties of the stent are essential for a rational selection of the appropriate stent in selected lesions and patients.

KEYWORDS:

• Mechanical properties
• mechanical performance
• radial strength
• stent fracture
• stent recoil
• longitudinal stent deformation
• drug-eluting stent

Declaration of interest

P Chichareon reports receiving research grant from Biosensors, outside the submitted work.

R Modolo reports receiving research grant from Biosensors, outside the submitted work.

N Kukreja reports grants from Dalcor Pharma, grants from Population Health Research Institute, grants from European Cardiovascular Research Institute, grants from Daiichi Sankyo, personal fees from Astra Zeneca, personal fees from Pfizer, outside the submitted work.

JJ Piek reports non-financial support from Member medical advisory board Abbott Vascular, personal fees and non-financial support from Consultant Philips/Volcano, outside the submitted work.

PW Serruys reports personal fess from Abbott Laboratories, AstraZeneca, Biotronik, Cardialysis, GLG Research, Medtronic, Sino Medical Sciences Technology, Societe Europa Digital Publishing, Stentys France, Svelte Medical Systems, Philips/Volcano, St. Jude Medical, Qualimed, and Xeltis outside the submitted work.

Y Onuma reports that he was a member of advisory board of Abbott vascular, outside the submitted work.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

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Additional information

Funding

This paper was not funded.