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International Journal of Bioprinting Coronary and peripheral artery disease. State of the art.

1. Introduction 5%–8% prevalence of CAD and 10%–20% prevalence
of PAD, dependent on the study design, average age,
Atherosclerosis and thrombosis are vascular conditions that gender, and geographical location” . Another recent
[5]
represent one of the major causes of death worldwide [1-3] , report from the American Heart Association states that
thus placing a substantial medical and economic burden to the lifetime risk of PAD has been estimated between 19%
society. The progressive and chronic accumulation of fat in and 30% depending on the race, from white to black
artery walls, which is initially asymptomatic, can ultimately people, respectively . Chronic ulceration is one of the
[6]
lead to the production of atheroma that blocks the vessel major problems of PAD, which could ultimately lead
lumen, thus jeopardizing blood circulation. Moreover, to amputation. Ulceration in these patients is related to
atheroma plaques can also suffer from ruptures, causing disturbed microcirculation, swelling and edema . Due
[7]
local problems such as thrombosis, arterial wall ulcers, and to the silent nature of atherosclerosis, it is very common
dissection. If atherosclerosis happens in coronary arteries for patients to suffer from cardiovascular events, thus
(coronary artery disease [CAD]), the blockage of the blood needing hospitalization, surgery, and pharmacological
flow could lead to myocardial infarction and ultimately, treatments. Both CAD and PAD have demonstrated to be
death. If stenosis is located in other blood vessels of the a significant economic burden on different health systems
peripheral circulatory system, it is known as peripheral (Figure 1A). In particular, PAD represents a higher
artery disease (PAD). Even if PAD can affect any blood economic expense than CAD, especially due to a worse
vessel, it is more common in the lower extremities than prognosis. In patients with PAD, cardiac complications
in the arms. It is also worth to clarify that PAD and CAD are the major cause of morbidity and mortality. Moreover,
could have different causes, but atherosclerosis remains the peripheral lesions are more complex and vaster than
one of the most common causes.
coronary ones .
[8]
Different medical approaches can be performed According to a recent market study made by IMARC
depending on the risk, age, stage of the condition, type Group Company, they expect the vascular stent (VS)
of lesion, etc. Normally, when the artery blockage is market to steadily grow in the coming years. They ascribe
severe, cardiologits resort to endovascular procedures or this growth to the increasing trend of geriatric population
open vascular reconstruction. Regarding endovascular as well as to a rise in the incidence rate of PAD, aortic
procedures, balloon angioplasty or endovascular stent are aneurysm and ischemic heart disease . Nevertheless, if
[9]
the most extended methods for treating the complications we look into the global VS market by product type, it is
of atherosclerosis. also clear that the majority of the efforts are centered on
Up to 42% of CAD patients have PAD, and half coronary stents (Figure 1B), relegating peripheral stents
of those patients are asymptomatic . According to to a secondary place, despite being the condition with
[4]
Bauersachs et al., “worldwide data showed approximately the most economic expenditure. In view of the above,

Figure 1. (A) Economic burden caused by CAD and PAD in France, Germany, and Canada. Left: average cumulative 1-year and 2-year direct medical
costs associated with hospitalization/patient for both CAD and PAD (H stands for “hospitalization”). Extracted from Smolderen et al. [145] Right: Average
hospitalization and annual medication costs per patient in Canada. Extracted from Bauersachs et al. . Bars numbers correspond to amount in euros. (B)
[5]
Global vascular stents market share by product type. EVAR stands for “endovascular aortic repair.” Values extracted from .
[9]
Volume 9 Issue 2 (2023) 220 https://doi.org/10.18063/ijb.v9i2.664