The use of biodegradable stent in peripheral arterial diseases: a systemic review of current evidence

Abstract

Introduction: For the last decade, the use of biodegradable stent has been intensely studied. With a major benefit of disappearing completely overtime, it appears to be an ideal treatment that circumvents the chronic local inflammatory reaction seen in traditional metal stents. The aim of this paper is to examine the published literature on the use of biodegradable stents in the treatment of peripheral arterial diseases (PAD). Methods: Systematic review was formulated under the instruction of PRIMSA guideline. A computerized search with PubMed, ProQuest central and Ovid MEDLINE, with a filter to show only studies published between January 2005 and March 2015 that were written in English. The search focused on the use of biodegradable stent in the treatment of peripheral vascular diseases (PAD) using relevant keywords. On-going studies from other electronic databases were also examined. Results: A total of 75 non-duplicated publications were identified but only 6 articles were eligible into our qualitative analysis (one animal study, 3 case-cohort studies, and 2 randomised studies). In total, 325 stents were used in 282 patients. Technical success rates were 100%. These studies had a short to medium follow-up period up to 58 months. The primary and secondary patency rates were 60.8% (range 32-77%) and 88.4% (range 79-97%) respectively. There are also four on-going studies internationally. Conclusions: Current published literature suggests that biodegradable stent is safe and effective in the treatment of PAD, but these studies were heterogeneous and were limited by their study design, small sample size, and short follow-up period; and therefore do not produce a sufficient level of evidence to show its superiority over traditional treatments.