Analysis of Fully Biodegradable Polymer Stent Use Within Coronary Artery Disease

Abstract

Coronary artery disease (CAD) is the most common type of heart disease, with about 20.5 million adults having CAD in the U.S, as of 2023. This disease is caused by plaque buildup beneath the endothelium of the arteries that supply blood to the heart, called coronary arteries. Currently, durable polymer drug eluting stents (DP-DES) are most typically used in treatment of this disease, due to lower rates of complications compared to older generation stents. However, fully biodegradable stents have recently been developed and studied within preclinical studies and promising clinical trials. In order to evaluate the association between biodegradable polymer stent use and clinical outcomes, as compared to DP-DES use, a meta-analysis of clinical trials and data available in respect to the in-stent restenosis and target lesion failure (TLF) rates of biodegradable stents, and of DP-DESs, was conducted. Critically, this study has found that the efficacy of fully biodegradable stents is not significantly different from the more commonly used DP-DESs, when analyzed in the general patient population, and in the diabetic patient population. In addition, several novel biodegradable polymers were identified, which demonstrate promise in being used to create new and more effective biodegradable stents. Overall, the findings of this study have highlighted the potential of fully biodegradable stents, encouraging future research in the development and clinical testing of new biodegradable stents.