Thromboresistance and endothelial healing in polymer-coated versus polymer-free drug-eluting stents: Implications for short-term dual anti-platelet therapy
| Autor: | Atsushi Sakamoto, Frank D. Kolodgie, Liang Guo, Hiroyuki Jinnouchi, Anne Cornelissen, Renu Virmani, Qi Cheng, Matthew Kutyna, Yu Sato, Stefan Tunev, Rashmi Wijeratne, Christine Janifer, Aloke V. Finn |
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| Rok vydání: | 2021 |
| Předmět: |
Drug
Bare-metal stent Polymers Swine media_common.quotation_subject medicine.medical_treatment Polymer free Coronary Artery Disease 030204 cardiovascular system & hematology Prosthesis Design 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Animals Humans Medicine In patient 030212 general & internal medicine media_common business.industry Dual Anti-Platelet Therapy Stent Drug-Eluting Stents Anti platelet Treatment Outcome Drug-eluting stent Stents Rabbits Cardiology and Cardiovascular Medicine business Shunt (electrical) Biomedical engineering |
| Zdroj: | International Journal of Cardiology. 327:52-57 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2020.11.030 |
| Popis: | Background Short-term dual antiplatelet therapy (DAPT) is a suitable strategy after stent implantation especially in patients at high risk for bleeding. The thromboresistant characteristics and the healing profile permanent polymer stents such as the Resolute Onyx- drug-eluting stent (DES) has never been tested against the current approved stents for short-term DAPT, the polymer free (PF) biolimus-eluting stent (PF-BES) and bare metal stents (BMS) in dedicated preclinical models. Methods An ex-vivo porcine arteriovenous shunt and in-vivo flow loop model were used to evaluate thromboresistance. The healing profile was assessed in the rabbit model at 28 days by confocal microscopy (CM), scanning electron microscopy (SEM) and histology. Onyx-DES was separately compared with Onyx-BMS in first experiment and PF-BES in second experiment. Results In an ex-vivo shunt model, CM and SEM showed significantly less platelet adhesion for Onyx-DES relative to Onyx-BMS and PF-BES. In a flow loop model using human blood, platelet adhesion was also significantly less in Onyx-DES as compared to PF-BES and Onyx-BMS. In the healing study, Onyx-BMS showed significantly greater healing profile relative to Onyx-DES as expected, whereas Onyx-DES showed equivalent endothelial coverage by SEM and significantly less Evan's blue uptake and comparable colocalization of p120 and vascular endothelial-cadherin when compared with PF-BES. Conclusions Onyx-DES showed qualities of thomboresistance and healing which appear to be compatible with short-term DAPT. Thromboresistance was superior to PF-BES and healing was equivalent to PF-BES in this pre-clinical study. Onyx-DES might provide advantages when considering short-term DAPT especially in patients at high risk of bleeding. |
| Databáze: | OpenAIRE |
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