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(Circulation. 2000;102:371.)
© 2000 American Heart Association, Inc.

Editorial

Biodegradable Stents

"Fulfilling the Mission and Stepping Away"

Antonio Colombo, MD; Evangelia Karvouni, MD

From Centro Cuore Columbus, Milan, Italy.

Correspondence to Antonio Colombo, MD, Centro Cuore Columbus, Via Buonarroti 48, 20 145 Milan, Italy. E-mail columbus@micronet.it

Key Words: Editorials • stents • absorbable implants • restenosis • thrombosis

In 458 BC, a prominent Roman leader named Lucius Quintius Cincinnatus was unique in his behavior. Cincinnatus served his country when he was needed and, after fulfilling his duty, he returned to his private life.¹ We now see a new medical device, a biodegradable stent, that mimics this historical figure.

The 2 main functions of a stent, treatment of dissection and prevention of restenosis, refer to 2 events that occur and progress in a set frame of time. Coronary dissections are effectively contained by stent insertion and undergo a healing process, with the majority of cardiac events occurring in the first 6 months.² In-stent restenosis also occurs within the first 6 months.³ Therefore, a permanent prosthesis that is in place beyond this initial period has no clear function.

Besides lacking a well-defined function, are there any negative aspects related to the presence of a permanent coronary implant?

Zidar et al⁴ stated that one of the main reasons to develop a biodegradable stent was the short-term need for a stent and the potential long-term complications of metal stents.

Kimura et al³ demonstrated, with an extended angiographic follow-up of 3 years, that the presence of a metallic stent does not seem to be associated with lesion progression or accelerated atherosclerosis of the treated site after 6 months. In fact, late improvement in luminal diameter seems to occur between 6 months and 3 years. The Belgian Netherlands Stent Study (BENESTENT I) recently extended its follow-up to 5 years and demonstrated a sustained and . . . [Full Text of this Article]

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