Abstract
Balloon angioplasty and stent implantation are standard techniques to reopen stenotic vessels. Often, balloons or stents coated with cytostatic drugs are used to prevent re-occlusion of the arteries. Resveratrol, which is known for its numerous beneficial effects on cardiovascular health, is used as an antioxidant additive on paclitaxel-coated balloon catheters. What is still unclear is whether resveratrol-only balloon coating in combination with a bare metal stent (BMS) also has positive effects on vascular healing. Here, we analyzed neointimal thickening, fibrin deposition, inflammation, vasa vasorum density, and reendothelialization after implantation of BMS via a resveratrol coated balloon approach in a porcine model. In general, resveratrol treatment did not result in significantly altered responses compared to the control group in peripheral arteries. In coronary arteries, an increase in vasa vasorum density became evident three days after resveratrol treatment compared to the control group and abolished up to day 7. Significant effects of the resveratrol treatment on the fibrin score or intima-media area were transient and restricted to either peripheral or coronary arteries. In conclusion, local single-dose resveratrol treatment via a resveratrol-only coated balloon and BMS approach did not lead to adverse systemic or local effects, but also no significant beneficial effects on vascular healing were detected in the current study.
Highlights
Percutaneous transluminal angioplasty, which is often combined with stent implantation, is a standard procedure to dilate or reopen vascular stenoses
We demonstrated that resveratrol as a dry balloon catheter coating has beneficial effects on vascular healing in mildly, but not severely injured arteries [20]
The feasibility and pharmacokinetic of resveratrol as a dry balloon catheter coating, 4–7 μg resveratrol/mm2 balloon surface, with a premounted bare metal stent (BMS) was analyzed with focus on the amount of resveratrol transferred into the vessel wall
Summary
Percutaneous transluminal angioplasty, which is often combined with stent implantation, is a standard procedure to dilate or reopen vascular stenoses. The vascular damage induces numerous biological processes such as inflammation, vasa vasorum neovascularization, reendothelialization, and neointima proliferation. The balance of these processes determines the extent to which vascular healing restores the physiological state of the vessel. Restenosis is one of the most common complications after frequently used angioplasty procedures, and among others is characterized by vascular smooth muscle cell (VSMC) proliferation. Cytostatic drugs such as paclitaxel or sirolimus are used as stent or balloon coatings to suppress exaggerated VSMC proliferation. Therapies that inhibit restenosis while supporting reendothelialization and vascular healing are a continuing therapeutic need
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