Key result
Bioresorbable polymer everolimus-eluting stents resulted in lower long-term area stenosis and inflammation compared to permanent polymer DES in a swine model.
Why the study?
Do bioresorbable polymer everolimus-eluting stents reduce long-term neointimal formation and inflammation compared to permanent polymer DES in a swine model of coronary stenosis?
Do bioresorbable polymer everolimus-eluting stents reduce long-term neointimal formation and inflammation compared to permanent polymer DES in a swine model of coronary stenosis?
p-value: p=<0.05
In a swine model, bioresorbable polymer everolimus-eluting stents demonstrated lower long-term neointimal formation and inflammation compared to permanent polymer drug-eluting stents.
Does not support changing stent selection in patients; leaves open translation of swine benefits to human trials.
AIMS: Drug-eluting stents (DES) have evolved to using bioresorbable polymers as a method of drug delivery. The impact of bioresorbable polymer on long-term neointimal formation, inflammation, and healing has not been fully characterised. This study aimed to evaluate the biological effect of polymer resorption on vascular healing and inflammation. METHODS AND RESULTS: A comparative DES study was performed in the familial hypercholesterolaemic swine model of coronary stenosis. Permanent polymer DES (zotarolimus-eluting [ZES] or everolimus-eluting [EES]) were compared to bioresorbable polymer everolimus-eluting stents (BP-EES) and BMS. Post implantation in 29 swine, stents were explanted and analysed up to 180 days. Area stenosis was reduced in all DES compared to BMS at 30 days. At 180 days, BP-EES had significantly lower area stenosis than EES or ZES. Severe inflammatory activity persisted in permanent polymer DES at 180 days compared to BP-EES or BMS. Qualitative para-strut inflammation areas (graded as none to severe) were elevated but similar in all groups at 30 days, peaked at 90 days in DES compared to BMS (p<0.05) and, at 180 days, were similar between BMS and BP-EES but were significantly greater in DES. CONCLUSIONS: BP-EES resulted in a lower net long-term reduction in neointimal formation and inflammation compared to permanent polymer DES in an animal model. Further study of the long-term neointima formation deserves study in human clinical trials.
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Wilson et al. (2018) studied Coronary stenosis (n=29). Bioresorbable polymer everolimus-eluting stents (BP-EES) vs. Permanent polymer DES (ZES or EES) and bare metal stents (BMS) was evaluated on Area stenosis and qualitative para-strut inflammation (p=<0.05). Bioresorbable polymer everolimus-eluting stents resulted in lower long-term area stenosis and inflammation compared to permanent polymer DES in a swine model.
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