Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
Catheter Cardiovasc Interv. 2012 Feb 1;79(2):231-42. doi: 10.1002/ccd.22928. Epub 2011 Aug 10.
To study the effect of endothelial progenitor cell (EPC) capture on the vascular response to coronary stenting.
The introduction of drug-eluting stents has reduced the need for target lesion revascularization, but their effect on delayed healing, inflammation, and vascular dysfunction has emphasized the need to design strategies that improve current DES. One such strategy is to improve endothelialization by capturing CD34-positive cells (EPC) by the stent surface. The first human clinical trial using coronary EPC capture stents showed stent safety but neointimal thickness (NIT) was not reduced compared to bare metal stents (BMS). To understand these responses we studied the coronary response to the EPC capture stent in swine.
The stent, coated with murine antihuman monoclonal CD34 antibodies, was assessed with QCA guided stent implantation in normal swine coronary arteries for early endothelialization at 2 and 5 days, and NIT at 28 and 90 days in comparison to control stents carrying a non-specific murine antibody or to BMS. The main finding was that while the EPC capture stent significantly improved early endothelialization it did not reduce NIT at 28 and 90 days.
The EPC capture stent improves early endothelialization in swine but this does not affect neointimal thickness as compared to control stents at 28 and 90 days.
研究内皮祖细胞(EPC)捕获对冠状动脉支架血管反应的影响。
药物洗脱支架的引入减少了对靶病变血运重建的需求,但它们对延迟愈合、炎症和血管功能障碍的影响强调了需要设计改善现有 DES 的策略。一种这样的策略是通过支架表面捕获 CD34 阳性细胞(EPC)来改善内皮化。首例使用冠状动脉 EPC 捕获支架的人体临床试验显示支架安全性,但与裸金属支架(BMS)相比,新生内膜厚度(NIT)并未降低。为了了解这些反应,我们在猪中研究了 EPC 捕获支架对冠状动脉的反应。
该支架用抗人鼠单克隆 CD34 抗体包被,用于在正常猪冠状动脉中进行 QCA 引导的支架植入,以评估 2 天和 5 天的早期内皮化,以及 28 天和 90 天的 NIT,与携带非特异性鼠抗体的对照支架或 BMS 进行比较。主要发现是,尽管 EPC 捕获支架显著改善了早期内皮化,但与 28 天和 90 天的对照支架相比,它并没有降低 NIT。
EPC 捕获支架可改善猪的早期内皮化,但与 28 天和 90 天的对照支架相比,它不会影响新生内膜厚度。