Document Detail


Differential healing responses in polymer- and nonpolymer-based sirolimus-eluting stents.
MedLine Citation:
PMID:  19463356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We compared the healing and inflammatory responses of polymer-free bare-metal stents (BMS), polymer-free sirolimus-eluting stents (SES) and polymer-free sirolimus-eluting stents plus estradiol (SES+ED) to Cypher drug-eluting stents (CDES) in a rabbit model of overlapping stent placement.
BACKGROUND: Inflammatory responses to polymers and delayed healing remain important safety issues associated with CDES. Whether nonpolymeric stents that elute sirolimus or sirolimus and estradiol provoke less inflammation and heal better is unknown.
METHODS: Twenty-eight rabbits received 2 overlapping stents in each iliac artery: SES, SES+ED, BMS, or CDES, and vessels were harvested at 28 days for histology and scanning electron microscopy.
RESULTS: Although similar at nonoverlapping segments, neointimal thickness within the overlap site of CDES was significantly less than in SES, SES+ED, and BMS (0.07 +/- 0.04 mm vs. 0.16 +/- 0.03 mm, 0.14 +/- 0.03 mm, and 0.15 +/- 0.03 mm, p < 0.0001). Endothelialization was greater in SES, SES+ED, and BMS compared with CDES in nonoverlapping sections (80.0 +/- 5.0% vs. 95.3 +/- 5.0%, 97.5 +/- 2.5%, and 96.7 +/- 3.8%; p = 0.0028) and overlapping sections (85.8 +/- 2.9% vs. 90.8 +/- 6.3%, 89.2 +/- 6.3%, and 48.3 +/- 2.9%; p < 0.0001). The number of luminal eosinophils was also less in overlapping sections of SES, SES+ED, and BMS versus CDES but was similar in nonoverlapping sections.
CONCLUSIONS: Polymer-free stents coated with SES or SES+ED result in less robust neointimal suppression but markedly improved arterial healing compared with CDES in the rabbit model.
Authors:
Michael C John; Rainer Wessely; Adnan Kastrati; Albert Schömig; Michael Joner; Mayu Uchihashi; Johanna Crimins; Scott Lajoie; Frank D Kolodgie; Herman K Gold; Renu Virmani; Aloke V Finn
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  1     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-06-11     Revised Date:  2012-08-29    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  535-44     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Massachusetts General Hospital, Boston, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon / adverse effects,  instrumentation*
Animals
Cardiovascular Agents / administration & dosage*
Cytokines / metabolism
Drug-Eluting Stents*
Fibrinolytic Agents / therapeutic use
Iliac Artery / drug effects*,  injuries,  metabolism,  ultrastructure
Inflammation / etiology,  metabolism,  pathology,  prevention & control*
Intercellular Signaling Peptides and Proteins / metabolism
Metals
Microscopy, Electron, Scanning
Models, Animal
Organ Culture Techniques
Polymers*
Prosthesis Design
Rabbits
Sirolimus / administration & dosage*
Stents*
Wound Healing / drug effects*
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 0/Cytokines; 0/Fibrinolytic Agents; 0/Intercellular Signaling Peptides and Proteins; 0/Metals; 0/Polymers; 53123-88-9/Sirolimus

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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