Abstract
Objectives We evaluated the effect of the different carrier systems on early vascular response through histological analysis and scanning electron microscopy using a porcine model. Background Although Synergy™ and Promus PREMIER™ share an identical stent material and drug elution (everolimus), they use different drug carrier systems: biodegradable abluminal coating polymer or durable conformal coating polymer, respectively. However, data regarding the impact of the different coating systems on vessel healing are currently limited. Methods Twelve Synergy™ and Promus PREMIER™ were implanted in 12 swine. Histopathological analysis of the stented segments was performed on the 2nd and 14th days after implantation. Morphometric analysis of the inflammation and intimal fibrin content was also performed. Results On the 2nd day, neointimal thickness, percentage of neointimal area, and inflammatory and intimal fibrin content scores were not significantly different between the two groups. On the 14th day, the inflammatory and intimal fibrin content scores were significantly lower in Synergy™ versus those observed in Promus PREMIER™. In Synergy™, smooth muscle cells were found and the neointimal layers were smooth. In contrast, inflammatory cells were observed surrounding the struts of Promus PREMIER™. Conclusions These results demonstrate that termination of reactive inflammation is accelerated after abluminal coating stent versus implantation of conformal coating stent.
Highlights
Drug-eluting stents (DES) were developed for reduction of in-stent restenosis after implantation of stents [1, 2]
DES have been associated with delayed vascular healing, which may lead to the occurrence of late complications [4,5,6]
Local reaction to the polymer coating may exacerbate the inflammatory reaction caused by the implantation of stent [7]. us, delayed endothelialization of the stent struts and positive vessel remodeling may occur, resulting in increased rates of late complications. erefore, it is important to examine the effects of the stent coating systems on early vascular response
Summary
Drug-eluting stents (DES) were developed for reduction of in-stent restenosis after implantation of stents [1, 2]. DES have been associated with delayed vascular healing, which may lead to the occurrence of late complications [4,5,6]. Local reaction to the polymer coating may exacerbate the inflammatory reaction caused by the implantation of stent [7]. Us, delayed endothelialization of the stent struts and positive vessel remodeling may occur, resulting in increased rates of late complications. Corporation, Marlborough, MA, USA) have been made of the same material (but the structure is different) and eluting drug (i.e., everolimus).
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