Effect of stents coated with a combination of sirolimus and alpha-lipoic acid in a porcine coronary restenosis model

Abstract

The aim of this study was to evaluate antiproliferative sirolimus- and antioxidative alpha-lipoic acid (ALA)-eluting stents using biodegradable polymer [poly-L-lactic acid (PLA)] in a porcine coronary overstretch restenosis model. Forty coronary arteries of 20 pigs were randomized into four groups in which the coronary arteries had a bare metal stent (BMS, n = 10), ALA-eluting stent with PLA (AES, n = 10), sirolimus-eluting stent with PLA (SES, n = 10), or sirolimus- and ALA-eluting stent with PLA (SAS, n = 10). A histopathological analysis was performed 28 days after the stenting. The ALA and sirolimus released slowly over 30 days. There were no significant differences between groups in the injury or inflammation score; however, there were significant differences in the percent area of stenosis (56.2 ± 11.78% in BMS vs. 51.5 ± 12.20% in AES vs. 34.7 ± 7.23% in SES vs. 28.7 ± 7.30% in SAS, P < 0.0001) and fibrin score [1.0 (range 1.0-1.0) in BMS vs. 1.0 (range 1.0-1.0) in AES vs. 2.0 (range 2.0-2.0) in SES vs. 2.0 (range 2.0-2.0) in SAS, P < 0.0001] between the four groups. The percent area of stenosis based on micro-computed tomography corresponded with the restenosis rates based on histopathological stenosis in different proportions in the four groups (54.8 ± 7.88% in BMS vs. 50.4 ± 14.87% in AES vs. 34.5 ± 7.22% in SES vs. 28.9 ± 7.22% in SAS, P < 0.05). SAS showed a better neointimal inhibitory effect than BMS, AES, and SES at 1 month after stenting in a porcine coronary restenosis model. Therefore, SAS with PLA can be a useful drug combination for coronary stent coating to suppress neointimal hyperplasia.

Coronary stents with inducible VEGF/HGF-secreting UCB-MSCs reduced restenosis and increased re-endothelialization in a swine model

“…Imaging analyses for stenosis evaluation were performed as previously described 24 . Briefly, a follow-up coronary angiogram was performed 4 weeks post-stent transplantation.…”

Promising Role of Polylactic Acid as an Ingenious Biomaterial in Scaffolds, Drug Delivery, Tissue Engineering, and Medical Implants: Research Developments, and Prospective Applications

“…By adding surfactants such as ethylene oxide or propylene oxide in the blend of PDLLA/PLLA, a potential implant for orthopedic and dental applications can be prepared [ 92 ]. The commercialization of drug-eluting stents prepared from the blend of PLA is under consideration by several pharma companies [ 93 ]. Nanofibers produced from PLA/PCL embedded by 5-fluoro uracil are also used as drug-eluting stents to treat cancer [ 94 , 95 , 96 ].…”

Effect of Novel Polymer-Free Nitrogen-Doped Titanium Dioxide Film–Coated Coronary Stent Loaded With Mycophenolic Acid

“…The bare metal stent was fabricated using a laser cutting machine (Rofin, Starcut, Hamburg, Germany) according to Chonnam National University Hospital (CNUH) stent design (Lim et al, 2013). The stent was coated with everolimus (20 mg) and PLLA (20 mg) using an ultrasonic spray coating system according to a previously reported method (Lim et al, 2016). Preparation of TiO 2 Film-Coated Stent With MPA TiO 2 thin film was deposited onto a CNUH BMS (3.0 × 16 mm) using the PECVD technique.…”