Kang Min-Kyu, Heo Seon-Hee, Yoon Jeong-Kee
Department of Systems Biotechnology, Chung-Ang University, Anseong-Si, Republic of Korea.
Department of surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Tissue Eng Part B Rev. 2024 Sep 12. doi: 10.1089/ten.TEB.2024.0178.
Arterial stenosis caused by atherosclerosis often requires stent implantation to increase the patency of target artery. However, such external devices often lead to in-stent restenosis due to inadequate re-endothelialization and subsequent inflammatory responses. Therefore, re-endothelialization strategies after stent implantation have been developed to enhance endothelial cell recruitment or to capture circulating endothelial progenitor cells. Notably, recent research indicates that coating stent surfaces with biogenic materials enhances the long-term safety of implantation, markedly diminishing the risk of in-stent restenosis. In this review, we begin by describing the pathophysiology of coronary artery disease and in-stent restenosis. Then, we review the characteristics and materials of existing stents used in clinical practice. Lastly, we explore biogenic materials aimed at accelerating re-endothelialization, including extracellular matrix, cells, and extracellular vesicles. This review helps overcome the limitations of current stents for cardiovascular disease and outlines the next phase of research and development.
动脉粥样硬化引起的动脉狭窄通常需要植入支架以提高靶动脉的通畅性。然而，由于再内皮化不足和随后的炎症反应，此类外部装置常常导致支架内再狭窄。因此，已经开发出支架植入后的再内皮化策略，以增强内皮细胞募集或捕获循环内皮祖细胞。值得注意的是，最近的研究表明，用生物材料涂覆支架表面可提高植入的长期安全性，显著降低支架内再狭窄的风险。在本综述中，我们首先描述冠状动脉疾病和支架内再狭窄的病理生理学。然后，我们回顾临床实践中使用的现有支架的特性和材料。最后，我们探讨旨在加速再内皮化的生物材料，包括细胞外基质、细胞和细胞外囊泡。本综述有助于克服当前心血管疾病支架的局限性，并概述了下一阶段的研发方向。
