Coronary intimal proliferation after balloon injury and stenting in swing: An animal model of restenosis

Karas, Steven P.; Gravanis, Michael B.; Santoian, Edward C.; Robinson, Keith A.; Anderberg, Kristin A.; King, Spencer B.

doi:10.1016/0735-1097(92)90119-8

Cited by 346 publications

(150 citation statements)

References 28 publications

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“…Experimental studies have shown that the degree of inflammation and subsequent neointima formation is proportional to the degree of penetration of the stent struts into the vessel wall (12). Moreover, a foreign body immune response directed against the stent struts has been shown in a porcine model of coronary artery injury (23,24) and in humans (25). Multinucleated giant cells, indicative of a chronic inflammatory response, are occasionally present in the peri-strut area one month after stent insertion in pig coronary arteries (24).…”

Section: Inflammationmentioning

confidence: 99%

The cell cycle: A critical therapeutic target to prevent vascular proliferative disease

Charron

Nili

Strauss

2006

Canadian Journal of Cardiology

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Section: Inflammationmentioning

confidence: 99%

The cell cycle: A critical therapeutic target to prevent vascular proliferative disease

Charron

Nili

Strauss

2006

Canadian Journal of Cardiology

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“…However, the stent implant itself can act as a stimulus for intimal hyperplasia, particularly if the stent becomes imbedded in the vessel wall, leading to inflammation. [4][5][6] Compared with balloon angioplasty-induced restenosis, in-stent restenosis is largely the consequence of intimal hyperplasia. These lesions are highly cellular with some inflammatory cell infiltrate but composed primarily of phenotypically modulated smooth muscle cells displaying a high frequency of cell cycle protein expression (PCNA, cdk2 and cyclin E).…”

Section: Introductionmentioning

confidence: 99%

Transgene delivery of plasmid DNA to smooth muscle cells and macrophages from a biostable polymer-coated stent

Takahashi

Palmer-Opolski²,

Smith

et al. 2003

Gene Ther

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Metallic stents coated with a polyurethane emulsion containing plasmid DNA were implanted in rabbit iliac arteries to evaluate transgene delivery and expression in the vessel wall. The expression of the plasmid-encoded marker genes, b-galactosidase, luciferase and green fluorescence protein (GFP), were evaluated at 7 days after implantation. In all cases, plasmid transfer was confined to the vessel wall at the site of stent implantation, plasmid DNA was not observed in vessel segments immediately proximal or distal to the stent and dissemination of plasmid DNA to lung, liver or spleen was not observed. Expression of transgenes occurred only in vessel segments in contact with the stent and analysis of the GFP expression pattern revealed a high frequency of marker protein-positive cells occurring at or near the luminal surface. The extent of transgene expression was dependent upon the quantity of DNA loaded onto the stent and no signal was detected in vessel segments that received polymer-coated stents lacking plasmid DNA. Of significance, colocalization studies identified transgene expression not only in vascular smooth muscle cells but also in macrophages. Hence, polymer-coated stents provide a new capability for transgene delivery to immune cells that are believed to contribute to the development of in-stent restenosis.

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“…In the attempt of achieving the ideal balance between healing and suppression of neointimal hyperplasia previous animal studies (19,25) have established a significant correlation between the degree of arterial injury caused by the metallic wire coils and the resultant neointimal thickness and lumen stenosis at the stented site. The restenosis and occlusion after initially successful percutaneous procedures seem to be, in a large extent, due to the excessive formation of neointimal tissue in response to the unavoidable injury that occurs during balloon dilation and stent implantation.…”

Section: Discussionmentioning

confidence: 99%

Effect of a novel drug-eluted balloon coated with Genistein before stent implantation in porcine coronary arteries

et al. 2008

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This is an author version of the contribution published on: Questa è la versione dell'autore dell'opera: [Effect of a novel drug-eluted balloon coated with genistein before stent implantation in porcine coronary arteries.Sheiban I, Anselmino M, Moretti C, Biondi-Zoccai G, Galloni M, Vignolini C, Mattoni M, Sciuto F, Omedè P, Trevi GP. Clin Res Cardiol. 2008 Dec;97(12):891-8. doi: 10.1007/s00392-008-0705-2.] The definitive version is available at: La versione definitiva è disponibile alla URL: [http://link.springer.com/article/10.1007%2Fs00392-008-0705-2] Phone: +39-011-6334446. Fax: +39-0116967053. Email: isheiban@yahoo.com 3 Background. The major drawback of stent implantation in native human coronary vessels is the occurrence of restenosis. Drug-eluting stents significantly reduce restenosis after percutaneous coronary intervention (PCI), but may be associated with persistent local inflammation involved in the restenosis mechanisms. In this setting coating coronary devices with anti-inflammatory agents represents an intriguing alternative to stent-based local drug delivery. The aim of the present study was to test in a porcine model the safety and efficacy of a novel Genistein-eluting balloon preceding coronary stenting.Design. Female piglets underwent PCI in a randomized fashion with either a Genistein-eluting or a standard balloon angioplasty, followed in all vessels by bare-metal stent implantation. Pigs were sacrificed at different time points to appraise safety (i.e. endothelialization) and efficacy (i.e. antiinflammatory and anti-proliferative effects): 1, 4, and 6-8 weeks following PCI.Results. Overall analysis was conducted on 14 piglets. Twenty-five bare-metal stents were implanted preceded by angioplasty with a conventional balloon in 13 vessels and by the Genistein-eluted balloon in 12. No untoward effects were reported in either group. Healing and endothelialization appeared universal within four weeks. The Genistein-eluted balloon group disclosed a significant reduction, at four weeks from implantation, of the peri-stent inflammatory cells count (mononucleocytes 39±32 vs.96±29 per square millimetre, p=0.019. This effect did not clearly translate into a trend towards a reduced neointimal hyperplasia at six-eight weeks (0.13±0.11 vs. 0.14±0.09, p=0.835).Conclusion. This study provides the first in vivo demonstration of the anti-inflammatory effects of a Genistein-eluting balloon in PCI, warranting further research including the combination of a Genisteineluting balloon with standard drug-eluting stent.4

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Coronary intimal proliferation after balloon injury and stenting in swing: An animal model of restenosis

Cited by 346 publications

References 28 publications

The cell cycle: A critical therapeutic target to prevent vascular proliferative disease

The cell cycle: A critical therapeutic target to prevent vascular proliferative disease

Transgene delivery of plasmid DNA to smooth muscle cells and macrophages from a biostable polymer-coated stent

Effect of a novel drug-eluted balloon coated with Genistein before stent implantation in porcine coronary arteries

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