Recent trends on the stent research for blood arteries by bibliometric analysis
© Ahn et al.; licensee BioMed Central Ltd. 2014
Received: 29 August 2014
Accepted: 5 October 2014
Published: 6 November 2014
The research trends on stent for blood arteries are reviewed by bibliometric analysis using 7,790 journal articles published from 1986 to 2013 of the Web of Science database. The bibliometric indicators are applied to analyze the journal article data, which are simple number of publications for selecting key players, citation indicators for measuring qualitative research performance, collaboration indicators for figuring out the degree of international collaboration and keyword mapping for identifying the research trends. The studies of stent for blood arteries are investigated on the basis of the analysis by countries, institutions and topic changing. The leading countries and institutions published many high-quality journal articles with strong international collaboration. In this report, the current status and future of research trends are clearly revealed from the periodic topic changing analysis. The keywords such as ‘drug eluting stent’, ‘stent coated with new polymers’ and ‘drug delivery systems’ have come into the recent stent-related research, which means lots of efforts are under way to overcome the present limitations of the research.
KeywordsStent Blood artery Drug-eluting stent Blood coagulation Biomaterials
A stent is a small mesh tube to be used to treat weak and narrow arteries. Normal arteries are blood vessels that are able to carry blood away from heart to other parts of human body. However, problems occur sometimes in the arteries of old or sick people. In the case of good chance, a stent is placed in an artery as part of a procedure called percutaneous coronary intervention (PCI). PCI restores blood flow through narrow or blocked arteries of the body. A replaced stent helps support the inner wall of the artery within a certain period of time for few months or years after putting on PCI.
Some stents are coated with polymeric drugs that are slowly and continuously released into the artery. The stents are called drug-eluting stents (DES). Introducing DES, several problems have been reduced dramatically in coronary artery stenting by limiting long-term efficacy . The medicine helps prevent the artery from coming blocked again. Recently, researches have indicated that the reduction in restenosis might have been obtained at the expense of a higher incidence of stent thrombosis, particularly late stent thrombosis .
In the present paper, recent progress has been reviewed on the stent coating for heart blood arteries of human body. The research trends of the stent coating for heart blood arteries are reviewed using 7,790 journal articles published from 1986 to 2013 in various aspects.
Search query for the analysis of research trends on stent for blood arteries
TS = (stent* and ((bio* near/3 stent*) or “biodegradable polymer*” or “biocompatible polymer*” or “biocompatible material*” or “biomaterial*” or anti-coagulant* or “biomedical coating” or “biomedical implant*” or “drug-eluting” or “drug elut*” or “drug delivery coating system”))
PY = 1986 ~ 2013 document type = ‘article’
The research performance should be considered quantitatively as well as qualitatively. If the simple number of publications is used as a quantitative indicator, the widely known indicator for research quality measurement is based on citation. Here, we have used the quality-factor(Q-factor), which is defined as the average number of citations per publication(CPP) of a country compared to the world-wide average CPP in a given research field . It could be regarded that the research level is over world average level when the Q-factor is more than 1. The Netherlands shows 1.64 as the highest Q-factor and Canada (1.45), UK (1.39), France (1.31), USA (1.23), Italy (1.15) and Germany (1.14) show the values over 1.
Quantitative and qualitative indicators for top-10 countries of the stent-related research
No. of pub.
No. of collab.
The top-20 institutions in the field of stent research
No. of pub.
Cardiovasc Res Fdn.
Washington Hosp Ctr.
Boston Sci Corp.
Cleveland Clin Fdn.
Seoul Natl Univ.
Brigham & Womens Hosp.
Tech Univ. Munich
Univ. Hosp Bern
Mt Sinai Med Ctr.
Shanghai Jiao Tong Univ.
The Period I during first 10 years from 1986 to 1995 is the beginning stage. As shown in Figure 7, the words such as ‘stent’, ‘restenosis’, ‘biocompatible’ are appeared with a few frequencies. The Period II (1996 ~ 2005) could be regarded as a time of differentiation. Figure 8 shows that the number of keywords are rapidly increased and diversified as the advances of research on stent. The remarkable keywords are ‘coronary artery disease’, ‘drug eluting stent’, ‘thrombosis’, ‘inflammation’, ‘drug-coated stent’, and so on. Period III (2006 ~ 2013) is called as the time of expansion and stabilization. As seen in Figure 9, ‘drug eluting stent’ is emerging as a main topic of stent-related research and keywords such as ‘paclitaxel’, ‘sirolimus’, ‘drug delivery’, ‘zotarolimus’, ‘everolimus biodegradable polymer’, ‘endothelial function’ stand out as being representative words. We are able to know that many efforts are under way to overcome the present limitations of stent such as thrombosis. These keywords network analysis results correspond to the previous reports on development of stent-related research .
Since the first stent was implanted in human coronary arteries by Puel and Sigwart in 1986, the advances of interventional treatment of coronary artery disease was remarkably progressed. It was results from the continuous development of the medical kits including stents, the accumulative experiences of operators and use of new antiplatelets . Nowadays, stent coated with new polymeric drugs may have different activities in terms of affecting endothelium and vascular inflammation. Polymeric drug coating with NO-donors may decrease platelet adhesion and coagulation. Stent coated with polymeric CD34-antibodies may be able to prevent thrombosis by accelerating endothelial coverage and may capture circulating endothelial progenitor cells. Furthermore, development of biodegradable stents might also be useful way to decrease the incidence of late thrombosis on the stent. Anti-thrombotic therapy may be likely to be optimized with the development of more newly efficient anti-coagulant and anti-platelet drugs with a lower risk of bleeding complications [9, 10].
The research trends on stent for blood arteries are reviewed by bibliometric analysis using 7,790 journal articles of Web of Science database published from 1986 to 2013. We have applied the bibliometric indicators to analyze the journal article data, which contain simple number of publications for selecting key players, citation indicators for measuring qualitative research performance, collaboration indicators for figuring out the degree of international collaboration and keyword mapping for identifying the research trends. The stent-related research has been performed in 71 countries including USA, Germany, Italy, etc. The countries at the forefront published many high-quality journal articles with strong international collaboration. The top-20 institutions such as Columbia University, Cardiovascular Research Foundation, Harvard University, etc. are also investigated as the core institutions on stent-related research. On the basis of the keyword network maps as time period, the research trends in a view of topic changing are finally explored. The topics such as ‘drug eluting stent’, ‘stent coated with new polymers’ and ‘drug delivery systems’ are prominent lately, which means lots of efforts are under way to overcome the present limitations of stent-related research such as thrombosis and polymeric drug coatings. The future of stent is expected to be more perspective on developing of innovative ‘biodegradable/bioabsorbable’ polymer and stents.
Authors gratefully acknowledge the support of the Korea Institute for Science and Technology Information under the research program “Development of Exploring Support System on Global Future Technologies (K-14-L03-C01-S02)”, “Development of emergence indicators based on journal‧patent growth pattern analysis (K-14-L06-C07-S01)” and the Ministry of Science, ICT and Future Planning under the research program “ReSEAT Program (G-14-GM-IR05)”.
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