Stampfl Ulrike, Sommer Christof-Matthias, Thierjung Heidi, Stampfl Sibylle, Lopez-Benitez Ruben, Radeleff Boris, Berger Irina, Richter Goetz M
Department of Radiology, University of Heidelberg, INF 110, 69120 Heidelberg, Germany.
Cardiovasc Intervent Radiol. 2008 Nov-Dec;31(6):1184-92. doi: 10.1007/s00270-008-9392-7. Epub 2008 Aug 13.
The purpose of this study was to investigate the potential of nanoscale coating with the highly biocompatible polymer Polyzene-F (PZF), in combination with cobalt chromium and stainless steel stents, to reduce in-stent stenosis, thrombogenicity, and vessel wall injury and inflammation. One bare cobalt chromium, PZF-nanocoated stainless steel or PZF-nanocoated cobalt chromium stent was implanted in right coronary artery of 30 mini-pigs (4- or 12-week follow-up). Primary study end points were in-stent stenosis and thrombogenicity. Secondary study end points were vessel wall injury and inflammation as evaluated by microscopy and a new immunoreactivity score applying C-reactive protein (CRP), tumor-necrosis factor alpha (TNFalpha), and TGFbeta. At 12 weeks, angiography showed a significantly lower average loss in lumen diameter (2.1% +/- 3.05%) in PZF-nanocoated cobalt chromium stents compared with stents in the other groups (9.73% +/- 4.93% for bare cobalt chromium stents and 9.71% +/- 7% for PZF-nanocoated stainless steel stents; p = 0.04), which was confirmed at microscopy (neointima 40.7 +/- 16 lm in PZF-nanocoated cobalt chromium stents, 74.7 +/- 57.6 lm in bare cobalt chromium stents, and 141.5 +/- 109 lm in PZF-nanocoated stainless steel stents; p = 0.04). Injury and inflammation scores were low in all stents and were without significant differences. PZF-nanocoated cobalt chromium stents provided the highest efficacy in reducing in-stent stenosis at long-term follow-up. The PZF nanocoat proved to be biocompatible with respect to thromboresistance and inflammation. Our data suggest that its combination with cobalt chromium stents might provide an interesting passive stent platform.
本研究的目的是探讨用具有高度生物相容性的聚合物聚烯-F（PZF）进行纳米级涂层，结合钴铬合金和不锈钢支架，以减少支架内狭窄、血栓形成以及血管壁损伤和炎症的可能性。将一枚裸钴铬合金支架、PZF纳米涂层不锈钢支架或PZF纳米涂层钴铬合金支架植入30只小型猪的右冠状动脉（随访4周或12周）。主要研究终点为支架内狭窄和血栓形成。次要研究终点为通过显微镜检查以及应用C反应蛋白（CRP）、肿瘤坏死因子α（TNFα）和转化生长因子β（TGFβ）的新免疫反应评分评估的血管壁损伤和炎症。在12周时，血管造影显示，与其他组的支架相比，PZF纳米涂层钴铬合金支架的管腔直径平均损失显著更低（2.1%±3.05%，裸钴铬合金支架为9.73%±4.93%，PZF纳米涂层不锈钢支架为9.71%±7%；p = 0.04），显微镜检查证实了这一点（PZF纳米涂层钴铬合金支架的新生内膜为40.7±16μm，裸钴铬合金支架为74.7±57.6μm，PZF纳米涂层不锈钢支架为141.5±109μm；p = 0.04）。所有支架的损伤和炎症评分均较低，且无显著差异。在长期随访中，PZF纳米涂层钴铬合金支架在减少支架内狭窄方面疗效最高。PZF纳米涂层在抗血栓形成和炎症方面被证明具有生物相容性。我们的数据表明，它与钴铬合金支架的结合可能提供一个有趣的被动支架平台。
