Thromboresistance and endothelial healing in polymer-coated versus polymer-free drug-eluting stents : Implications for short-term dual anti-platelet therapy

Copyright © 2020 Elsevier B.V. All rights reserved..

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.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:327

Enthalten in:

International journal of cardiology - 327(2021) vom: 15. März, Seite 52-57

Sprache:

Englisch

Beteiligte Personen:

Jinnouchi, Hiroyuki [VerfasserIn]
Sato, Yu [VerfasserIn]
Cheng, Qi [VerfasserIn]
Janifer, Christine [VerfasserIn]
Kutyna, Matthew [VerfasserIn]
Cornelissen, Anne [VerfasserIn]
Wijeratne, Rashmi [VerfasserIn]
Sakamoto, Atsushi [VerfasserIn]
Guo, Liang [VerfasserIn]
Kolodgie, Frank D [VerfasserIn]
Tunev, Stefan [VerfasserIn]
Virmani, Renu [VerfasserIn]
Finn, Aloke V [VerfasserIn]

Links:

Volltext

Themen:

Bare metal stent
Coronary artery disease
Drug-eluting stent
Journal Article
Polymers
Stent thrombosis

Anmerkungen:

Date Completed 28.05.2021

Date Revised 28.05.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.ijcard.2020.11.030

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM318090538