Advanced

Differential response of delayed healing and persistent inflammation at sites of overlapping sirolimus- or paclitaxel-eluting stents

Finn, A V; Kolodgie, F D; Harnek, Jan LU ; Guerrero, L J; Acampado, E; Tefera, K; Skorija, K; Weber, D K; Gold, H K and Virmani, R (2005) In Circulation 112(2). p.270-278
Abstract
Background - Although effective coverage of challenging coronary lesions has warranted the use of overlapping drug-eluting stents, the histopathological response to stent overlap is unknown. Methods and Results - The arterial reaction to overlapping Cypher or Taxus drug-eluting stents was examined in rabbits with bare metal stents, BxVelocity or Express, serving as controls. Single iliac artery balloon injury was followed by placement of 2 overlapping 3.0-mm-diameter drug-eluting stents or bare metal stents in 60 animals ( mean length of overlap, 9.8 +/- 3.6 mm). Stented arteries were harvested at 28 and 90 days for histology. Overlapped segments exhibited delayed healing compared with proximal and distal nonoverlapping sites at 28 days.... (More)
Background - Although effective coverage of challenging coronary lesions has warranted the use of overlapping drug-eluting stents, the histopathological response to stent overlap is unknown. Methods and Results - The arterial reaction to overlapping Cypher or Taxus drug-eluting stents was examined in rabbits with bare metal stents, BxVelocity or Express, serving as controls. Single iliac artery balloon injury was followed by placement of 2 overlapping 3.0-mm-diameter drug-eluting stents or bare metal stents in 60 animals ( mean length of overlap, 9.8 +/- 3.6 mm). Stented arteries were harvested at 28 and 90 days for histology. Overlapped segments exhibited delayed healing compared with proximal and distal nonoverlapping sites at 28 days. Overlapped segments in Taxus stents induced significantly more luminal heterophils/eosinophils and fibrin deposition than Cypher; peristrut giant cell infiltration, however, was more frequent in the latter. Overlapping bare metal stents also showed mild delayed healing compared with nonoverlapped segments, but not to the same extent as drug-eluting stents. Although neointimal thickness within the overlap was similar in 28- and 90-day Cypher stents, there was a significant increase with Taxus (P = 0.03). Conclusions - Compared with bare metal stents, drug-eluting stents further delay arterial healing and promote inflammation at sites of overlap. Taxus stents induced greater fibrin deposition, medial cell loss, heterophils/eosinophils, and late neointimal hyperplasia. Patients receiving overlapping drug-eluting stents need more frequent follow-up than patients with nonoverlapping stents. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
pathology, restenosis, drugs, stents
in
Circulation
volume
112
issue
2
pages
270 - 278
publisher
Lippincott Williams and Wilkins
external identifiers
  • wos:000230427300019
  • pmid:15998681
  • scopus:22144474043
ISSN
1524-4539
DOI
10.1161/CIRCULATIONAHA.104.508937
language
English
LU publication?
yes
id
07d47953-0e95-486d-ae67-1608e8a2f6ea (old id 233149)
date added to LUP
2007-08-08 14:51:32
date last changed
2017-10-22 04:49:22
@article{07d47953-0e95-486d-ae67-1608e8a2f6ea,
  abstract     = {Background - Although effective coverage of challenging coronary lesions has warranted the use of overlapping drug-eluting stents, the histopathological response to stent overlap is unknown. Methods and Results - The arterial reaction to overlapping Cypher or Taxus drug-eluting stents was examined in rabbits with bare metal stents, BxVelocity or Express, serving as controls. Single iliac artery balloon injury was followed by placement of 2 overlapping 3.0-mm-diameter drug-eluting stents or bare metal stents in 60 animals ( mean length of overlap, 9.8 +/- 3.6 mm). Stented arteries were harvested at 28 and 90 days for histology. Overlapped segments exhibited delayed healing compared with proximal and distal nonoverlapping sites at 28 days. Overlapped segments in Taxus stents induced significantly more luminal heterophils/eosinophils and fibrin deposition than Cypher; peristrut giant cell infiltration, however, was more frequent in the latter. Overlapping bare metal stents also showed mild delayed healing compared with nonoverlapped segments, but not to the same extent as drug-eluting stents. Although neointimal thickness within the overlap was similar in 28- and 90-day Cypher stents, there was a significant increase with Taxus (P = 0.03). Conclusions - Compared with bare metal stents, drug-eluting stents further delay arterial healing and promote inflammation at sites of overlap. Taxus stents induced greater fibrin deposition, medial cell loss, heterophils/eosinophils, and late neointimal hyperplasia. Patients receiving overlapping drug-eluting stents need more frequent follow-up than patients with nonoverlapping stents.},
  author       = {Finn, A V and Kolodgie, F D and Harnek, Jan and Guerrero, L J and Acampado, E and Tefera, K and Skorija, K and Weber, D K and Gold, H K and Virmani, R},
  issn         = {1524-4539},
  keyword      = {pathology,restenosis,drugs,stents},
  language     = {eng},
  number       = {2},
  pages        = {270--278},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Circulation},
  title        = {Differential response of delayed healing and persistent inflammation at sites of overlapping sirolimus- or paclitaxel-eluting stents},
  url          = {http://dx.doi.org/10.1161/CIRCULATIONAHA.104.508937},
  volume       = {112},
  year         = {2005},
}