Inception to actualization: Next generation coronary stent coatings incorporating nanotechnology

Percutaneous coronary intervention (PCI) is used to treat blocked coronary arteries. Bare-metal stents (BMS) were first used in PCI but often necessitated repair procedures due to in-stent restenosis. Drug-eluting stents (DES) were developed to address this problem as the stent-incorporated anti-proliferative drugs prevented restenosis. However late-stent thrombosis arose with the use of DES due to polymer hypersensitivity and impaired re-endothelialization. Evidence suggests that using a combination of biofunctionalized polymers and antibody/peptide motifs can prevent thrombosis while ensuring in situ endothelialization. The advent of nanotechnology has engendered techniques like layer-by-layer self-assembly, and localized drug and gene delivery using nanoparticles. Therefore, this review seeks to explore the convergence of biotechnology and nanotechnology for the next generation coronary stent coatings, with an emphasis on its development from bench to beside.

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► We discuss the unresolved problems in drug-eluting stents (DES).
► We discuss the various nanotechnology-based techniques in the development of the next generation of DES.
► We discuss the various tests required prior to FDA approval.