Drug-eluting stents (DESs) have profoundly affected the field of interventional cardiology as a transformative technology by dramatically reducing the problem of in-stent restenosis. However, the development of adverse, late stent thrombosis (LST) raises the question of the safety profile of the DES. The aim of the study is to develop better DESs that can increase the amount of drug (sirolimus) loading while slowing down the drug release rate and potentially eliminating the polymer, all of which are expected to aid in the prevention of LST. Nanosecond pulsed laser texturing of Nitinol stent surfaces was first performed and the surface topography was analyzed using an optical profilometer. The results showed that the surface texture parameters such as surface area ratio, its roughness, volume of fluid retained per unit area, and mean valley slope suitable for drug adhesion, retention, and elution were significantly increased due to laser texturing. Subsequently, the drug elution profiles were studied for four different types of stents: laser-textured and untreated stents coated with the drug only and the drug-polymer. Laser texturing reduced the cumulative sirolimus release from 73% to 25% in drug only coated stents and from 93% to 45% in drug-polymer coated stents and showed promise for applying polymer-free drug coatings on the DES.

References

References
1.
Hunter
,
W.
, 2006, “
Drug-Eluting Stents: Beyond the Hyperbole
,”
Adv. Drug Delivery Rev.
,
58
(
3
), pp.
347
349
.
2.
Daemen
,
J.
and
Serruys
,
P.
, 2007, “
Drug-Eluting Stent Update 2007
,”
Circulation
,
116
(
8
), pp.
316
328
.
3.
Burt
,
H. M.
and
Hunter
W. L.
, 2006, “
Drug-Eluting Stents: A Multidisciplinary Success Story
,”
Adv. Drug Delivery Rev.
,
58
(
3
), pp.
350
357
.
4.
Van der Hoeven
,
B.
,
Pires
,
N.
,
Warda
,
H.
,
Oemrawsingh
,
P.
,
van Vlijmen
,
B.
,
Quax
,
P.
,
Schalij
,
M.
,
van der Wall
,
E.
, and
Jukema
,
J.
, 2005, “
Drug-Eluting Stents: Results, Promises and Problems
,”
Int. J. Cardiol.
,
99
(
1
), pp.
9
17
.
5.
Waksman
,
R.
, 2002, “
Drug-Eluting Stents: From Bench to Bed
,”
Cardiovasc. Radiat. Med.
,
3
(
3-4
), pp.
226
241
.
6.
Fattori
,
R.
and
Piva
,
T.
, 2003, “
Drug Eluting Stents in Vascular Intervention
,”
Lancet
,
361
(
9353
), pp.
247
249
.
7.
Costa
,
M. A.
and
Simon
,
D. I.
, 2005, “
Molecular Basis of Restenosis and Drug Eluting Stents
,”
Circulation
,
111
, pp.
2257
2273
.
8.
Chong
,
P. H.
and
Cheng
,
J. W. M.
, 2004, “
Early Experiences and Clinical Implications of Drug-Eluting Stents: Part 1
,”
Ann. Pharmacother.
,
38
(
4
), pp.
661
669
.
9.
Joner
,
M.
,
Finn
,
A. V.
,
Farb
,
A.
,
Mont
,
E. K.
,
Kolodgie
,
F. D.
, and
Ladich
,
E.
, 2006, “
Pathology of Drug-Eluting Stents in Humans: Delayed Healing and Late Thrombotic Risk
,”
J. Am. Coll. Cardiol.
,
48
(
1
), pp.
193
202
.
10.
van der Giessen
,
W. J.
,
Lincoff
,
A. M.
,
Schwartz
,
R. S.
,
van Beusekom
,
H. M.
,
Serruys
,
P. W.
, and
Holmes
,
D. R.
, 1996, “
Marked Inflammatory Sequelae to Implantation of Biodegradable and Nonbiodegradable Polymers in Porcine Coronary Arteries
,”
Circulation
,
94
(
7
), pp.
1690
1697
.
11.
Virmani
,
R.
,
Guagliumi
,
G.
,
Farb
,
A.
,
Musumeci
,
G.
,
Grieco
,
N.
, and
Motta
,
T.
, 2004, “
Localized Hypersensitivity and Late Coronary Thrombosis Secondary to a Sirolimus-Eluting Stent: Should We Be Cautious?
,”
Circulation
,
109
(
6
), pp.
701
705
.
12.
Nebeker
,
J. R.
,
Virmani
,
R.
,
Bennett
,
C. L.
,
Hoffman
,
J. M.
,
Samore
,
M. H.
, and
Alvarez
,
J.
, 2006, “
Hypersensitivity Cases Associated With Drug-Eluting Coronary Stents: A Review of Available Cases From the Research on Adverse Drug Events and Reports (RADAR) Project
,”
J. Am. Coll. Cardiol.
,
47
(
1
), pp.
175
181
.
13.
Windecker
,
S.
,
Simon
,
R.
,
Lins
,
M.
,
Klauss
,
V.
,
Eberli
,
F. R.
, and
Roffi
,
M.
, 2005, “
Randomized Comparison of a Titanium-Nitride-Oxide-Coated Stent With a Stainless Steel Stent for Coronary Revascularization: The TiNOX Trial
,”
Circulation
,
111
(
20
), pp.
2617
2622
.
14.
Rajtar
,
A.
,
Kaluza
,
G.
,
Yang
,
Q.
,
Hakimi
,
D.
,
Liu
,
D.
,
Tsui
,
M.
,
Lien
,
M.
,
Smith
,
D.
,
Clubb
,
F. J.
, Jr., and
Troczynski
,
T.
, 2006, “
Hydroxyapatite-Coated Cardiovascular Stents
,”
EuroIntervention
,
2
(
1
), pp.
113
115
.
15.
Acharya
,
G.
and
Park
,
K.
, 2006, “
Mechanisms of Controlled Drug Release From Drug-Eluting Stents
,”
Adv. Drug Delivery Rev.
,
58
(
3
), pp.
387
401
.
16.
Tada
,
N.
,
Virmani
,
R.
,
Grant
,
G.
,
Bartlett
,
L.
,
Black
,
A.
,
Clavijo
,
C.
,
Christians
,
U.
,
Betts
,
R.
,
Savage
,
D.
,
Su
,
S.-H.
,
Shulze
,
J.
, and
Kar
,
S.
, 2010, “
Polymer-Free Biolimus A9-Coated Stent Demonstrates More Sustained Intimal Inhibition, Improved Healing, and Reduced Inflammation Compared With a Polymer-Coated Sirolimus-Eluting Cypher Stent in a Porcine Model
,”
Circulation: Cardiovasc. Interventions
,
3
(
2
), pp.
174
183
.
17.
Windecker
,
S.
,
Serruys
,
P. W.
,
Wandel
,
S.
,
Buszman
,
P.
,
Trznadel
,
S.
,
Linke
,
A.
,
Lenk
,
K.
,
Ischinger
,
T.
,
Klauss
,
V.
,
Eberli
,
F.
,
Corti
,
R.
,
Wijns
,
W.
,
Morice
,
M. C.
,
di Mario
,
C.
,
Davies
,
S.
,
van Geuns
,
R. J.
,
Eerdmans
,
P.
,
van Es
,
G. A.
,
Meier
,
B.
, and
Jüni
,
P.
, 2008, “
Biolimus-Eluting Stent With Biodegradable Polymer Versus Sirolimus-Eluting Stent With Durable Polymer For Coronary Revascularisation (LEADERS): A Randomised Non-Inferiority Trial
,”
Lancet
,
372
(
9644
), pp.
1163
1173
.
18.
Ostojic
,
M.
,
Sagic
,
D.
,
Jung
,
R.
,
Zhang
,
Y. L.
,
Nedeljkovic
,
M.
,
Mangovski
,
L.
,
Stojkovic
,
S.
,
Debeljacki
,
D.
,
Colic
,
M.
,
Beleslin
,
B.
,
Milosavljevic
,
B.
,
Orlic
,
D.
,
Topic
,
D.
,
Karanovic
,
N.
,
Paunovic
,
D.
, and
Christians
,
U.
, 2008, “
The Pharmacokinetics of Biolimus A9 After Elution From the Nobori Stent in Patients With Coronary Artery Disease
,”
Cathet. Cardiovasc. Interventions
,
72
(
7
), pp.
901
908
.
19.
“TCT: Polymer-Free DES Shows Promise for Safety at One Year; Larger Studies to Follow,” 2010, http://pul.se/events/fa0693d307cba09afc2f8b421cbf028b.
20.
Thompson, M., 2009, “The Future of Drug-Eluting Stents Part I: Novel Next-Generation Designs,” Windhover Information Inc., http://www.zeman.rs/uploaded_files/news/MTI_DES%20LEAD%20NovDec09.pdf.
21.
Gershlick
,
A.
,
De Scheerder
,
I.
,
Chevalier
,
B.
,
Stephens-Lloyd
,
A.
,
Camenzind
,
E.
,
Vrints
,
C.
,
Reifart
,
N.
,
Missault
,
L.
,
Goy
,
J. J.
,
Brinker
,
J. A.
,
Raizner
,
A. E.
,
Urban
,
P.
, and
Heldman
,
A. W
, 2004, “
Inhibition of Restenosis With a Paclitaxel-Eluting, Polymer-Free Coronary Stent: The European evaLUation of pacliTaxel Eluting Stent (ELUTES) Trial
,”
Circulation
,
109
(
4
), pp.
487
493
.
22.
Mehilli
,
J.
,
Byrne
,
R. A.
,
Wieczorek
,
A.
,
Iijima
,
R.
,
Schulz
,
S.
,
Bruskina
,
O.
,
Pache
,
J.
,
Wessely
,
R.
,
Schömig
,
A.
, and
Kastrati
,
A.
, 2008, “
Randomized Trial of Three Rapamycin-Eluting Stents With Different Coating Strategies for the Reduction of Coronary Restenosis
,”
Eur. Heart J.
,
29
(
16
), pp.
1975
1982
.
23.
Wessely
,
R.
,
Kastrati
,
A.
, and
Schomig
,
A.
, 2005, “
Late Restenosis in Patients Receiving a Polymer-Coated Sirolimus-Eluting Stent
,”
Ann. Intern. Med.
,
143
(
5
), pp.
392
394
.
24.
Virmani
,
R.
,
Liistro
,
F.
,
Stankovic
,
G.
,
Di Mario
,
C.
,
Montorfano
,
M.
,
Farb
,
A.
,
Kolodgie
,
F. D.
, and
Colombo
,
A.
, 2002, “
Mechanism of Late In-Stent Restenosis After Implantation of a Paclitaxel Derivate-Eluting Polymer Stent System in Humans
,”
Circulation
,
106
(
21
), pp.
2649
2651
.
25.
Park
,
D. W.
,
Hong
,
M. K.
,
Mintz
,
G. S.
,
Lee
,
C. W.
,
Song
,
J. M.
,
Han
,
K. H.
,
Kang
,
D. H.
,
Cheong
,
S. S.
,
Song
,
J. K.
,
Kim
,
J. J.
,
Weissman
,
N. J.
,
Park
,
S. W.
, and
Park
,
S. J.
, 2006, “
Two-Year Follow-Up of the Quantitative Angiographic and Volumetric Intravascular Ultrasound Analysis After Nonpolymeric Paclitaxel-Eluting Stent Implantation: Late “Catch-Up” Phenomenon From ASPECT Study
,”
J. Am. Coll. Cardiol.
,
48
(
12
), pp.
2432
2439
.
26.
Farb
,
A.
,
Heller
,
P. F.
,
Shroff
,
S.
,
Cheng
,
L.
,
Kolodgie
,
F. D.
,
Carter
,
A. J.
,
Scott
,
D. S.
,
Froehlich
,
J.
, and
Virmani
,
R.
, 2001, “
Pathological Analysis of Local Delivery of Paclitaxel Via a Polymer-Coated Stent
,”
Circulation
,
104
(
4
), pp.
473
479
.
27.
Jee
,
Y.
,
Becker
,
M. F.
, and
Walser
,
R. M.
, 1988, “
Laser-Induced Damage on Single-Crystal Metal Surfaces
,”
J. Opt. Soc. Am.
,
5
(
3
), pp.
648
659
.
28.
Guosheng
,
Z.
,
Fauchet
,
P.
, and
Siegman
,
A.
, 1982, “
Growth of Spontaneous Periodic Surface Structures on Solids During Laser Illumination
,”
Phys. Rev. B
,
26
(
10
), pp.
5366
5381
.
29.
Siegman
,
A.
and
Fauchet
,
P.
, 1986, “
Stimulated Wood’s Anomalies on Laser-Illuminated Surfaces
,”
IEEE J. Quantum Electron.
,
22
, pp.
1384
1403
.
30.
Sipe
,
J. E.
,
Young
,
J. F.
,
Preston
,
J. S.
, and
van Driel
,
H. M.
, 1983, “
Laser Induced Periodic Surface Structure. I. Theory
,”
Phys. Rev. B
,
27
, pp.
1141
1154
.
31.
Young
,
J.
,
Preston
,
J.
,
van Driel
,
H.
, and
Sipe
,
J.
, 1983, “
Laser-Induced Periodic Surface Structure. II. Experiments on Ge, Si, Al and Brass
,”
Phys. Rev. B
,
27
, pp.
1155
1172
.
32.
Ozkan
,
A. M.
,
Malshe
,
A. P.
,
Railkar
,
T. A.
,
Brown
,
W. D.
,
Shirk
,
M. D.
, and
Molian
,
P. A.
, 1999, “
Femtosecond Laser-Induced Periodic Structure Writing on Diamond Crystals and Microclusters
,”
Appl. Phys. Lett.
,
75
(
23
), pp.
3716
3718
.
33.
Yasumaru
,
N.
,
Miyazaki
,
K.
, and
Kiuchi
,
J.
, 2003, “
Femtosecond-Laser-Induced Nanostructure Formed on Hard Thin Films of TiN and DLC
,”
Appl. Phys. A
,
76
(
6
), pp.
983
985
.
34.
Yasumaru
,
N.
,
Miyazaki
,
K.
, and
Kiuchi
,
J.
, 2005, “
Fluence Dependence of Femtosecond-Laser-Induced Nanostructure Formed on TiN and CrN
,”
Appl. Phys. A
,
81
(
5
), pp.
933
937
.
35.
Jost
,
D.
,
Luthy
,
W.
,
Weber
,
H.
, and
Saiathe
,
R.
, 1986, “
Laser Pulse Width Dependent Surface Ripples on Silicon
,”
Appl. Phys. Lett.
,
49
(
11
), pp.
625
627
.
36.
Dolgaev
,
S. I.
,
Lavrishev
,
S. V.
,
Lyalin
,
A. A.
,
Simakin
,
A. V.
,
Voronov
,
V. V.
, and
Shafeev
,
G. A.
, 2001, “
Formation of Conical Microstructures Upon Laser Evaporation of Solids
,”
Appl. Phys. A
,
73
(
2
), pp.
177
181
.
37.
Shen
,
M. Y.
,
Crouch
,
C. H.
,
Carey
,
J. E.
,
Younkin
,
R.
,
Mazur
,
E.
,
Sheehy
,
M.
, and
Friend
,
C. M.
, 2009, “
Formation of Regular Arrays of Silicon Microspikes by Femtosecond Laser Irradiation Through a Mask
,”
Appl. Phys. Lett.
,
82
(
11
), pp.
1715
1717
.
38.
Huang
,
M.
,
Zhao
,
F.
,
Cheng
,
Y.
,
Xu
,
N.
, and
Xu
,
Z.
, 2009, “
Origin of Laser-Induced Near-Subwavelength Ripples: Interference Between Surface Plasmons and Incident Laser
,”
ACS Nano
,
3
(
12
), pp.
4062
4070
.
39.
Shen
,
M. Y.
,
Crouch
,
C. H.
,
Carey
,
J. E.
, and
Mazur
,
E.
, 2004, “
Femtosecond Laser-Induced Formation of Submicrometer Spikes on Silicon in Water
,”
Appl. Phys. Lett.
,
85
(
22
), pp.
5694
5696
.
40.
Katayama
,
K.
,
Yonekubo
,
H.
, and
Sawada
,
T.
, 2003, “
Formation of Ring Patterns Surrounded by Ripples by Single-Shot Laser Irradiation With Ultrashort Pulse Width at the Solid/Liquid Interface
,”
Appl. Phys. Lett.
,
82
(
24
), pp.
4244
4246
.
41.
Nayak
,
B. K.
,
Gupta
,
M. C.
, and
Kolasinski
,
K. W.
, 2008, “
Formation of Nano-Textured Conical Microstructures in Titanium Metal Surface by Femtosecond Laser Irradiation
,”
Appl. Phys. A
,
90
(
3
), pp.
399
402
.
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