ABSTRACT
AIM: Coronary artery disease (CAD) is the leading cause of mortality. Though percutaneous transluminal angioplasty followed by stenting is still the default treatment of choice for revascularization of obstructive CAD, the high rate of restenosis compromises the outcomes of endovascular procedures. To overcome restenosis, drug-eluting stents (DES) and drug-coated balloons (DCB) are designed that release antiproliferative drugs like sirolimus, paclitaxel, everolimus, etc., over time to inhibit cell growth and proliferation. Our review aims to summarize the challenges and progress of DES/DCBs in clinical settings. MATERIAL AND METHODS: The comprehensive review, search and selection encompasses in relevant articles through Google Scholar, Springer online, Cochrane library and PubMed that includes research articles, reviews, letters and communications, various viewpoints, meta-analyses, randomized trials and quasi-randomized trials. Several preclinical and clinical data have been included from National Institutes of Health and clinicaltrials.gov websites. KEY FINDINGS: Challenges like delayed endothelialization, stent thrombosis (ST), and inflammation was prominent in first-generation DES. Second-generation DES with improved designs and drug coatings enhanced biocompatibility with fewer complications. Gradual absorption of bioresorbable DES over time mitigated long-term issues associated with permanent implants. Polymer-free DES addressed the inflammation concerns but still, they leave behind metallic stents in the vasculature. As an alternative therapeutic strategy, DCB were developed to minimize inflammation in the vessel. Although both DES and DCBs have shown considerable progress, challenges persist. SIGNIFICANCE: This review illustrates the advancements in the designs, preparation technologies, biodegradable materials, and drugs used as well as challenges associated with DES and DCBs in clinical settings.
ABSTRACT
Lignin, a versatile and abundant biomass-derived polymer, possesses a wide array of properties that makes it a promising material for biotechnological applications. Lignin holds immense potential in the biotechnology and pharmaceutical field due to its biocompatibility, high carbon content, low toxicity, ability to be converted into composites, thermal stability, antioxidant, UV-protectant, and antibiotic activity. Notably, lignin is an environmental friendly alternative to synthetic plastic and fossil-based materials because of its inherent biodegradability, safety, and sustainability potential. The most important findings related to the use of lignin and lignin-based materials are reported in this review, providing an overview of the methods and techniques used for their manufacturing and modification. Additionally, it emphasizes on recent research and the current state of applications of lignin-based materials in the biomedical and pharmaceutical fields and also highlights the challenges and opportunities that need to be overcome to fully realize the potential of lignin biopolymer. An in-depth discussion of recent developments in lignin-based material applications, including drug delivery, tissue engineering, wound dressing, pharmaceutical excipients, biosensors, medical devices, and several other biotechnological applications, is provided in this review article.
