Effect of local delivery of heparin and methotrexate on neointimal proliferation in stented porcine coronary arteries

Cox, David A.; Anderson, Peter G.; Roubin, Gary S.; Chou, Chien‐Chen; Agrawal, Sumit; Cavender, J. B.

doi:10.1097/00019501-199203000-00011

Cited by 34 publications

(14 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In some experiments, intracoronary artery stents (FlexStent, Cook, Inc) were deployed in pigs by using techniques similar to those described above and previously published. 22 …”

Section: Balloon Angioplasty Procedures For Swine Coronary Restenosismentioning

confidence: 99%

“…22 The animals were killed 7 days after stent implantation, and the hearts were removed as described above. The coronary arteries were dissected from the heart and placed in cold cell-isolation medium consisting of Dulbecco's modified minimal essential medium (DMEM) containing 20 mmol/L HEPES buffer, pH 7.4, 1 mg/mL bovine serum albumin, 5 g/mL amphotericin B, and 50 g/mL gentamicin.…”

Section: Western Blot Analysis For Pkg In Swine Neointimal and Medialmentioning

confidence: 99%

See 1 more Smart Citation

Cyclic GMP–Dependent Protein Kinase Expression in Coronary Arterial Smooth Muscle in Response to Balloon Catheter Injury

Anderson

Boerth

Liu

et al. 2000

ATVB

Self Cite

View full text Add to dashboard Cite

Abstract-Arterial smooth muscle cells undergo phenotypic and proliferative changes in response to balloon catheter injury. Nitric oxide (NO) and cGMP have been implicated in the inhibition of vascular smooth muscle cell proliferation and phenotypic modulation in cultured-cell studies. We have examined the expression of the major cGMP receptor protein in smooth muscle, cGMP-dependent protein kinase I (PKG), in response to balloon catheter injury in the swine coronary artery. On injury, there was a transient decrease in the expression of PKG in neointimal smooth muscle cells when compared with medial smooth muscle cells. The decrease in PKG expression was observed in the population of proliferating cells expressing the extracellular matrix protein osteopontin but not in cells present in the uninjured portion of the media. Coincident with the suppression of PKG expression in neointimal cells after injury, there was a marked increase in the expression of type II NO synthase (inducible NOS [iNOS], NOS-II) in the neointimal cells. These results suggest that PKG expression is transiently reduced in response to injury in the population of coronary arterial smooth muscle cells that are actively proliferating and producing extracellular matrix proteins. The reduction in PKG expression is also correlated temporally with increases in inflammatory activity in the injured vessels as assessed by iNOS expression. Coupled with our current knowledge regarding the role of PKG in the regulation of cultured cell phenotypes, these results imply that PKG may also regulate phenotypic modulation of vascular smooth muscle cells in vivo as well.

show abstract

“…In some experiments, intracoronary artery stents (FlexStent, Cook, Inc) were deployed in pigs by using techniques similar to those described above and previously published. 22 …”

Section: Balloon Angioplasty Procedures For Swine Coronary Restenosismentioning

confidence: 99%

Section: Western Blot Analysis For Pkg In Swine Neointimal and Medialmentioning

confidence: 99%

Cyclic GMP–Dependent Protein Kinase Expression in Coronary Arterial Smooth Muscle in Response to Balloon Catheter Injury

Anderson

Boerth

Liu

et al. 2000

ATVB

Self Cite

View full text Add to dashboard Cite

show abstract

“…10) To further improve the clinical results of coronary stenting, attention was directed to coating the stent with material that would reduce their inherent thrombogenicity and decrease the incidence of in-stent restenosis. 2,4,5,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Most coatings tested are placed mainly to provide a biologically inert barrier between the stent surface and the circulating blood. In contrast to these, immobilized-heparin surface coatings have been studied as means of providing a biologically active exterior that interacts with the circulating blood.…”

Section: Discussionmentioning

confidence: 99%

<b>Comparison of Initial Efficacy and Long-term Follow-up of Heparin-coated Jostent With Conventional NIR Stent</b>

et al. 2003

View full text Add to dashboard Cite

SUMMARYThe implantation of heparin-coated stents was reported to be well tolerated, but there are conflicting results about acute in-hospital complications, (sub)acute thrombosis rates, and long-term follow-up compared to uncoated stents. We compared the angiographic and clinical results after coronary placement of two stent models: the heparin-coated premounted Jostent and the uncoated premounted NIR stent. Of 710 patients revascularized, a total of 426 patients received Jostent (n = 230) or NIR stent (n = 196) implantation. The primary end points were acute or subacute thrombosis, urgent CABG, AMI or death, while the secondary end points were the comparison of the restenosis rates of the stents at the 6 th month and of the functional angina classification of the stent groups at the 1 st , 6 th and 12 th months. There were no significant differences between the Jostent and NIR stent groups regarding angiographic and procedural success. Acute thrombosis rates in the Jostent and NIR stent groups were similar while no subacute thrombosis was observed in either group. The major adverse cardiac event rates of the groups also did not differ. Angiographic restenosis occurred in 17% of the Jostent group and 16% of the NIR stent group (NS). The combined clinical and angiographic restenosis rate was also similar between the Jo and NIR groups (19% and 18%, respectively). Comparison of functional angina classes at the 1 st , 6 th and 12 th months revealed no significant difference between the study groups.In conclusion, when compared with implantation of an uncoated premounted NIR stent, implantation of a heparin-coated premounted Jostent does not provide any more benefit with respect to initial efficacy, sub(acute) thrombosis and 6-month restenosis rates and 12-month clinical outcomes. (Jpn Heart J 2003; 44: 889-898)

show abstract

“…Other researchers, using a similar model, failed to find a difference in neointimal formation between the control (bare metal stent) and the heparin-eluting stents. This is probably because the dose of heparin released from the cellulose ester polymer on the stent was too low to be effective (<0.001 U/hr released over the first week) [156]. A stent coated with 3.2 U of ionically bound heparin (which is readily released from the stent so it can be taken up by cells or available to neutralise thrombin [40]) reduced proliferation, thrombus formation and neointimal area in a similar pig model [157].…”

Section: Antithrombotic and Antiplateletmentioning

confidence: 99%

Targeted Treatments for Restenosis and Vein Graft Disease

Thomas

2012

ISRN Vascular Medicine

View full text Add to dashboard Cite

Surgery to restore blood flow in arteries blocked by atherosclerotic plaque is a common treatment in cardiovascular disease. Longterm complications of surgical treatment are vein graft disease and restenosis, a renarrowing of the blood vessel after bypass or removal of the culprit atherosclerotic plaque. Attempts to prevent or treat these complications by systemic pharmacological approaches have been largely unsuccessful in the clinic. This has led to an interest in developing targeted or locally delivered strategies. This paper discusses many of the various site-delivered therapies that are under examination as potential antirestenotic and antivein graft disease agents (including antithrombotic, antiproliferative, and anti-inflammatory agents) and why many therapies developed in animal models fail in clinical trials. Techniques of targeted delivery (including stents, "magic bullets," and adventitial delivery) and delivery systems (including nanoparticles and the use of gene therapy) are also discussed.

show abstract

Effect of local delivery of heparin and methotrexate on neointimal proliferation in stented porcine coronary arteries

Cited by 34 publications

References 0 publications

Cyclic GMP–Dependent Protein Kinase Expression in Coronary Arterial Smooth Muscle in Response to Balloon Catheter Injury

Cyclic GMP–Dependent Protein Kinase Expression in Coronary Arterial Smooth Muscle in Response to Balloon Catheter Injury

<b>Comparison of Initial Efficacy and Long-term Follow-up of Heparin-coated Jostent With Conventional NIR Stent</b>

Targeted Treatments for Restenosis and Vein Graft Disease

Contact Info

Product

Resources

About