Endothelial Cell Recovery Between Comparator Polymer-Based Drug-Eluting Stents

Joner, Michael; Nakazawa, Gaku; Finn, Aloke V.; Quee, Shawn Chin; Coleman, Leslie; Acampado, Eduardo; Wilson, Patricia S.; Skorija, Kristi; Cheng, Qi; Xu, Xin; Gold, Herman K.; Kolodgie, Frank D.; Virmani, Renu

doi:10.1016/j.jacc.2008.04.030

Cited by 604 publications

(436 citation statements)

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“…[8][9][10][11][12] The positive clinical results may reflect superior drug characteristics, polymer morphology, 13,14 and biocompatibility, [15][16][17] which may account for a better endothelialisation compared with older-generation DES. 18 When we started the present study no data from prospective randomised head-to-head comparisons between these two DES in a real-world scenario were available. Accordingly, the TWENTE study was designed to evaluate the clinical outcome of randomised use of Endeavor Resolute versus Xience V stents in a non-selected patient population.…”

mentioning

confidence: 99%

TWENTE Study: The Real-World Endeavor Resolute Versus Xience V Drug-Eluting Stent Study in Twente: study design, rationale and objectives

Basalus

Tandjung²,

Houwelingen³

et al. 2010

NHJL

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mentioning

confidence: 99%

TWENTE Study: The Real-World Endeavor Resolute Versus Xience V Drug-Eluting Stent Study in Twente: study design, rationale and objectives

Basalus

Tandjung²,

Houwelingen³

et al. 2010

NHJL

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“…In a recent paper, the same group of investigators compared endothelial coverage after implantation of four different DES (SES, PES, everolimus-eluting stent (EES) and ZES) for 14 and 28 days along with a BMS control in the rabbit iliac artery. 31 While the endothelialisation ratio decreased in this study compared with overlap stenting, they now reported a significant disparity in endothelialisation at 14 days as compared with 28 days. EES and BMS demonstrated a greater endothelial coverage above struts, but remained poorest in SES, followed by PES and ZES.…”

Section: Preclinical Studies On Endothelialisationmentioning

confidence: 50%

Late stent thrombosis, endothelialisation and drug-eluting stents

Ertaş

Beusekom²,

Giessen³

2009

NHJL

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Drug-eluting stents (DES) significantly reduce the risk of restenosis after percutaneous coronary revascularisation, but an increased risk of late stent thrombosis (LST) has been put forward as a major safety concern. Meta-analysis of clinical trials, however, does not support this caveat. Even so, many interventional cardiologists think that LST is associated with DES and related to delayed endothelialisation. This hypothesis is based on autopsy studies and clinical intracoronary angioscopy. In autopsy studies, differences between endothelialisation of DES and baremetal stents (BMS) have been reported. Most preclinical studies, however, have failed to show any significant differences in endothelialisation between DES and BMS. Our own studies, using the porcine coronary artery model, also suggest that DES show no differences in re-endothelialisation. However, DES do delay vascular healing and induce endothelial dysfunction. This paper will review clinical and animal studies which consider re-endothelialisation and LST. (Neth Heart J 2009;17:177-81.)Keywords: drug-eluting stents, stent thrombosis, endothelium, endothelial function P olymer-based sirolimus (SES) and paclitaxel (PES) eluting coronary stents have reduced rates of restenosis and late lumen loss compared with bare-metal stents (BMS), resulting in a significant reduction in the need for target vessel revascularisation. 1,2 Delayed healing and more specifically delayed re-endothelialisation after drug-eluting stent (DES) implantation have been suggested as the cause of late stent thrombosis (LST, defined as thrombosis ≥30 days after stent deployment). 3 This concept is based on clinical autopsy studies and clinical intracoronary angioscopy studies. 4,5 However we feel this concept is still open to debate. Our hypothesis is that delayed re-endothelialisation alone is not adequate to explain LST. The pathogenesis of LST is still not completely understood, and may be affected by a combination of factors. The present review discusses possible pathophysiological mechanisms of stent thrombosis in DES. DES induced late stent thrombosis, clinical studiesRecent reports from randomised trials suggest that some DES may be associated with increased rates of LST as compared with BMS. Stone et al. reported that both SES and PES were associated with a significant increase in the incidence of LST between one and four years after implantation (0.6 and 0.7%), as compared with BMS (0.2%). 6 Stettler and colleagues suggested that there is no evidence of an overall increase in definite stent thrombosis associated with SES between one and four years (0.3 vs. 0.2% in BMS). 7 However, the risk of LST seemed to be increased with PES (0.6%) with a significantly increased hazard ratio (2.1, p=0.017 vs. BMS between day 0 and 4 years). Garg and colleagues reported a small increase in DES thrombosis compared with BMS after one year (>0.14%/year). 8 This rate is, however, considerably lower than that reported by Daemen and Wenaweser and colleagues, who found that LST occurs in both D...

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“…Additionally, pre-clinical studies with stent implantation in animals with induced atherosclerosis are currently recommended 12,13 . When endothelialization data from Inspiron ® sirolimuseluting stents (Scitech ® , Goiânia, Brazil) are compared to the experimental data from Joner et al's study 14 as regards stent strut endothelialization, we verify that the Inspiron ® stent endothelialization rate (99%) is higher than that of other drug stents (Cypher ® : 64%, Taxus ® : 68%, Endeavor ® : 76% and Xience V ® : 80%) for the same observation period of four weeks post-implantation. This difference may result from the sirolimus elution only in the abluminal aspect in the Inspiron ® stent, whereas the antiproliferative drugs are released from both stent aspects in the other stents.…”

Section: Discussionmentioning

confidence: 99%