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Ultra-Hydrophilic Stent Platforms Promote Early Vascular Healing and Minimize Late Tissue Response - A Potential Alternative to Second-Generation Drug Eluting Stents


Kolandaivelu, Kumaran; Bailey, Lynn; Buzzi, Stefano; Zucker, Arik; Milleret, Vincent; Ziogas, Algirdas; Ehrbar, Martin; Khattab, Ahmed A; Stanley, James R; Wong, Gee K; Zani, Brett; Markham, Peter M; Tzafriri, Abraham R; Bhatt, Deepak L; Edelman, Elazer R (2017). Ultra-Hydrophilic Stent Platforms Promote Early Vascular Healing and Minimize Late Tissue Response - A Potential Alternative to Second-Generation Drug Eluting Stents. EuroIntervention, 12(17):2148-2156.

Abstract

AIMS Simple surface modifications can enhance coronary stent performance. Ultra-hydrophilic surface (UHS) treatment of contemporary bare metal stents (BMS) was assessed in vivo to verify whether they can provide long-term efficacy comparable to 2nd generation drug eluting stents (DES) while promoting healing comparably to BMS. METHODS AND RESULTS UHS-treated BMS, untreated BMS and corresponding DES were tested for 3 commercial platforms. 30- and 90-day porcine coronary model were used to characterize late tissue response. 3 day porcine coronary and 7 day rabbit iliac models were used for early healing assessment. In porcine coronary arteries, hydrophilic treatment reduced intimal hyperplasia relative to the BMS and corresponding DES platforms (1.5 to 3-fold reduction in 30-day angiographic and histological stenosis; p<0.04). Endothelialization was similar on UHS and BMS, both in swine and rabbit models, and lower on DES. Elevation in thrombotic indices was infrequent (never observed with UHS, rare with BMS, most often with DES), but when present, correlated with reduced endothelialization (p<0.01). CONCLUSIONS Ultra-hydrophilic surface treatment of contemporary stents conferred excellent healing while moderating neointimal and thrombotic responses. Such surfaces may offer safe alternatives to DES, particularly when rapid healing and short dual antiplatelet therapy (DAPT) are crucial.

Abstract

AIMS Simple surface modifications can enhance coronary stent performance. Ultra-hydrophilic surface (UHS) treatment of contemporary bare metal stents (BMS) was assessed in vivo to verify whether they can provide long-term efficacy comparable to 2nd generation drug eluting stents (DES) while promoting healing comparably to BMS. METHODS AND RESULTS UHS-treated BMS, untreated BMS and corresponding DES were tested for 3 commercial platforms. 30- and 90-day porcine coronary model were used to characterize late tissue response. 3 day porcine coronary and 7 day rabbit iliac models were used for early healing assessment. In porcine coronary arteries, hydrophilic treatment reduced intimal hyperplasia relative to the BMS and corresponding DES platforms (1.5 to 3-fold reduction in 30-day angiographic and histological stenosis; p<0.04). Endothelialization was similar on UHS and BMS, both in swine and rabbit models, and lower on DES. Elevation in thrombotic indices was infrequent (never observed with UHS, rare with BMS, most often with DES), but when present, correlated with reduced endothelialization (p<0.01). CONCLUSIONS Ultra-hydrophilic surface treatment of contemporary stents conferred excellent healing while moderating neointimal and thrombotic responses. Such surfaces may offer safe alternatives to DES, particularly when rapid healing and short dual antiplatelet therapy (DAPT) are crucial.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:20 April 2017
Deposited On:09 Feb 2017 12:26
Last Modified:28 May 2017 05:14
Publisher:Europa Digital and Publishing
ISSN:1774-024X
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.4244/EIJ-D-15-00497
PubMed ID:27993749

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