Safety and Efficacy of New Biodegradable Polymer-based Sirolimus-Eluting Stents in a Preclinical Model

Prado, Armando Pérez de; Pérez-Martínez, Claudia; Ramón, Carlos Cuellas; Purriños, Marta Regueiro; Benito, María López; Orden, José Manuel Gonzalo; Altónaga, José Antonio Rodríguez; Estévez‐Loureiro, Rodrigo; Benito‐González, Tomas; Baragaño, David Viñuela; Crisol, María Molina; Aguilar, Marc Amorós; Serranos, Isabel Pérez; Parreu, Arnau Vidal; Montegordo, Ana Benavides; Codina, Luis Duocastella; Vázquez, Felipe Fernández

doi:10.1016/j.rec.2017.05.021

Cited by 2 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Preclinical studies have reported that most struts were covered at 3 months after new-generation DES implantation. 17,18 However, in an autopsy study, vessel healing at the culprit site of patients with AMI treated with DES was substantially delayed compared with the culprit site of patients with SA receiving DES, emphasizing the importance of underlying plaque morphology in the arterial response to DES. 5 In accordance with the aforementioned histological findings, our serial OCT analyses confirmed that vascular healing of AMI was unfavorable and incomplete at early period despite the use of new-generation DES.…”

Section: Discussionmentioning

confidence: 99%

Differential Vascular Responses to New-Generation Drug-Eluting Stenting According to Clinical Presentation: Three-Month Optical Coherence Tomographic Study

et al. 2020

View full text Add to dashboard Cite

We evaluated early vascular responses after new-generation drug-eluting stent (DES) implantation. From 2 randomized trials, we identified 471 patients (138 patients with acute myocardial infarction [AMI] vs 333 patients with stable angina or unstable angina [SA/UA]) treated by DESs who underwent serial optical coherence tomography (OCT) from postprocedure to 3 months. At 3-month follow-up OCT, malapposed strut percentage was higher in AMI than in SA/UA (5.3% vs 0.7%, P < .001); it was markedly increased from postprocedure in AMI (2.0%-5.3%, P < .001), whereas it decreased in SA/UA (1.7%-0.7%, P < .001). Patients with AMI showed a higher risk of persistent (59% vs 37%; P < .001) or late-acquired malapposition (15% vs 8%; P = .04). Uncovered strut percentage at 3 months was also higher in AMI than in SA/UA (13.1% vs 6.7%, P < .001). The AMI presentation was the significant risk factor for both significant stent malapposition (SM, ≥200 μm; odds ratio [OR] = 3.45, CI = 1.85-7.14, P < .001) and uncovered stent (% uncovered struts >6.0%; OR = 2.44, CI = 1.35-4.76, P = .004), together with malapposed distance and postprocedural thrombi. Further, AMI presentation was the predictor for the occurrence of early period late-acquired and persistent malapposition. Serial OCT comparison analyses showed that patients with AMI compared with patients with SA/UA showed more delayed strut coverage, more severe degree SM or uncovered stents, and higher incidences of early period persistent or late-acquired SM.

show abstract

Section: Discussionmentioning

confidence: 99%

Differential Vascular Responses to New-Generation Drug-Eluting Stenting According to Clinical Presentation: Three-Month Optical Coherence Tomographic Study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Based in our previous experience (Estevez-Loureiro et al 2015;Perez de Prado et al 2017) and the vessel size measured, we used 3.00 mm diameter stents with different implantation pressures to achieve 1.2 stent to artery ratio. To implant the devices, we selected the best location out of the 3 epicardial coronary arteries.…”

Section: Animal Modelmentioning

confidence: 99%

“…However, it has been shown that the adventitia seems to be the primary early site for vessel wall response to arterial injury that occurs on the luminal side (Buccheri et al 2016). Detailed information about the media and (neo)intimal response to coronary stent implantation can be found elsewhere (Estevez-Loureiro et al 2015;Perez de Prado et al 2017). The precise role of the adventitial layer in modulating the neointimal response after coronary stenting has not been precisely established and it is controversial (Fleenor and Bowles 2009;Chang et al 2015).…”

mentioning

confidence: 99%

Adventitial histopathological changes after coronary stenting in a porcine model

Pérez‐Martínez¹,

Prado²,

Caballero-Manso³

et al. 2020

Vet. Med. - Czech

View full text Add to dashboard Cite

The adverse long-term events in first-generation drug-eluting stents were associated with chronic inflammatory response to the polymer. As an alternative, stents with biodegradable polymers emerged, whose effects on the vascular response are not yet fully known. Our objectives were to study the adventitial response to the stent implantation and the role of the polymeric vehicle. A histological (Haematoxylin-Eosin, Verhoeff van Gieson) and immunohistochemical (von Willebrand factor, alpha-smooth muscle actin) analysis were performed on resin-embedded arterial sections from fifteen Large White pigs, 28 days after the random implantation in the coronary arteries of: a chromium-cobalt stent and a stent coated with a permanent polyacrylate or biodegradable poly(D,L)-lactic-co-glycolic polymer, the two latter ones are loaded with sirolimus. Independent of the stent, the adventitial inflammation was associated with the adventitial area (P = 0.006 8) and the inflammation score (P = 0.037 1); and the adventitial actin-positive cells with the vascular damage (P = 0.001 2). A significant relationship was observed between the greater percentages of the restenosis and the more intense inflammation (P = 0.035 1) and the actin-positive cells (P = 0.011 9) in the adventitia. The polymeric vehicle increased the adventitial actin-positive cells (P = 0.018), independent of the type of polymer. The adventitial changes seem to be related to the restenosic process 28 days after the coronary stenting. Further investigations are necessary to confirm the role of the polymeric vehicle on the adventitial histopathological changes.

show abstract

Safety and Efficacy of New Biodegradable Polymer-based Sirolimus-Eluting Stents in a Preclinical Model

Cited by 2 publications

References 25 publications

Differential Vascular Responses to New-Generation Drug-Eluting Stenting According to Clinical Presentation: Three-Month Optical Coherence Tomographic Study

Differential Vascular Responses to New-Generation Drug-Eluting Stenting According to Clinical Presentation: Three-Month Optical Coherence Tomographic Study

Adventitial histopathological changes after coronary stenting in a porcine model

Contact Info

Product

Resources

About

Safety and Efficacy of New Biodegradable Polymer-based Sirolimus-Eluting Stents in a Preclinical Model

Cited by 2 publications

References 25 publications

Differential Vascular Responses to New-Generation Drug-Eluting Stenting According to Clinical Presentation: Three-Month Optical Coherence Tomographic Study

Differential Vascular Responses to New-Generation Drug-Eluting Stenting According to Clinical Presentation: Three-Month Optical Coherence Tomographic Study

Adventitial histopathological changes after coronary stenting in a porcine model

Contact Info

Product

Resources

About

Adventitial histopathological changes after coronary stenting in a porcine model