Key result
Biodegradable polymer SES show a trend toward greater neointimal regression versus durable polymer EES.
Why the study?
The BP-SES biodegradable polymer is fully resorbed after 3-4 months but may have longer-lasting effects, prompting evaluation of the long-term vascular response.
Does biodegradable polymer-based sirolimus-eluting stent improve neointimal volume regression and maturity compared to durable polymer everolimus-eluting stents and bare metal stents in a porcine model?
Does biodegradable polymer-based sirolimus-eluting stent improve neointimal volume regression and maturity compared to durable polymer everolimus-eluting stents and bare metal stents in a porcine model?
In a porcine model, biodegradable polymer sirolimus-eluting stents showed a trend toward greater late neointimal volume regression and maturity compared to durable polymer everolimus-eluting stents.
Answers are grounded in this paper and cite their sources.
Animal data insufficient to guide stent choice; leaves open whether biodegradable polymers improve late neointimal regression in humans.
The BP-SES has an abluminally applied biodegradable polymer that is fully resorbed after 3–4 months but may have longer-lasting effects. The aim of this study was to determine the long-term vascular response to the novel Ultimaster™ sirolimus-eluting stent (BP-SES). BP-SESs, everolimus-eluting stents (DP-EESs), and bare metal stents were implanted in 22 coronary arteries of 15 mini-swine. All animals underwent optical frequent domain imaging (OFDI) to assess neointimal volume and quality at either 1 (n = 7) or 3 (n = 8) months and at 9 (n = 15) months and were euthanized at 9 months. Stents were subsequently histologically investigated to analyze the vascular response and maturity of neointimal tissue according to cell density. OFDI revealed greater regression in neointimal volume from 3 to 9 months with BP-SESs than with DP-EESs (−0.6 ± 0.5 mm2 vs. 0.00 ± 0.4 mm2, p = 0.07). Although there was no significant difference between BP-SESs and DP-EESs in the inflammation score (BMS, BP-SES, and DP-EES: 0.1 ± 0.1, 0.3 ± 0.4, and 0.4 ± 0.4, respectively; p < 0.0001) in histological analysis, BP-SESs showed slightly greater maturity than DP-EESs (1.8 ± 0.3, 1.7 ± 0.3, and 1.6 ± 0.3, p = 0.09). While both BP-SESs and DP-EESs showed minimal inflammatory responses at 9 months, BP-SESs showed a trend for greater neointimal maturity and regression, which may be related to earlier completion of the vascular response.
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Ijichi et al. (2021) studied Coronary artery stenting (healthy porcine model) (n=17). Biodegradable polymer-based sirolimus-eluting stent (BP-SES) vs. Durable polymer-coated everolimus-eluting stent (DP-EES) and bare metal stent (BMS) was evaluated on Regression in neointimal volume from 3 to 9 months (mm²) (p=0.07). Biodegradable polymer-based sirolimus-eluting stents showed a trend toward greater neointimal volume regression from 3 to 9 months compared with durable polymer-coated everolimus-eluting stents.
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