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可生物吸收药物洗脱镁合金支架:在猪冠状动脉模型中的设计和可行性。

Bioresorbable drug-eluting magnesium-alloy scaffold: design and feasibility in a porcine coronary model.

机构信息

Biotronik SE & Co. KG, Erlangen, Germany.

出版信息

EuroIntervention. 2013 Apr 22;8(12):1441-50. doi: 10.4244/EIJV8I12A218.

Abstract

AIMS

Among three versions of bioresorbable magnesium scaffolds featuring different paclitaxel-elution kinetics, we determined the best-performing scaffold and compared it with established, paclitaxel-eluting, permanent stents TAXUS Liberté and eucaTAX.

METHODS AND RESULTS

Drug-elution kinetics in magnesium scaffolds were modulated by varying the composition of their bioresorbable poly(lactide-co-glycolide) coating loaded with paclitaxel. A 50:50 ratio of lactide to glycolide, or an 85:15 ratio and either high- or low-molecular-weight polymer was applied in the "50/50", "85/15H", and "85/15L" scaffolds, respectively. Seventy-three magnesium scaffolds (25 50/50, 24 85/15H, 24 85/15L) and 36 control stents (18 TAXUS Liberté, 18 eucaTAX) were implanted in coronary arteries of 50 Yucatan mini-pigs. Angiography, histomorphometry, and histopathology data were acquired at 28, 90 and 180 days. The best-performing magnesium scaffold, 85/15H, was equivalent to TAXUS Liberté and superior to eucaTAX regarding late luminal loss, intimal area, fibrin score, and endothelialisation. Intimal inflammation score was higher in 85/15H than in the control stents at 28 days, but this effect disappeared at later time points.

CONCLUSIONS

By selecting suitable paclitaxel-elution kinetics, it was feasible to develop a bioresorbable magnesium scaffold whose efficacy and healing characteristics in a porcine coronary model are comparable with those of established paclitaxel-eluting permanent metallic stents.

摘要

目的

在具有不同紫杉醇洗脱动力学的三种生物可吸收镁支架版本中,我们确定了表现最佳的支架,并将其与已建立的紫杉醇洗脱永久性支架 TAXUS Liberté 和 eucaTAX 进行了比较。

方法和结果

通过改变载有紫杉醇的可生物降解聚(乳酸-共-乙交酯)涂层的组成来调节镁支架中的药物洗脱动力学。50/50 支架采用丙交酯和乙交酯比例为 50:50 或 85:15 的比例,并分别使用高或低分子量聚合物;85/15L 支架采用 85:15H 和 85/15L 支架的比例为 85:15,分别应用高和低分子量聚合物。将 73 个镁支架(25 个 50/50、24 个 85/15H 和 24 个 85/15L)和 36 个对照支架(18 个 TAXUS Liberté 和 18 个 eucaTAX)植入 50 只尤卡坦迷你猪的冠状动脉中。在 28、90 和 180 天采集血管造影、组织形态计量学和组织病理学数据。表现最佳的镁支架 85/15H 在晚期管腔丢失、内膜面积、纤维蛋白评分和内皮化方面与 TAXUS Liberté 相当,优于 eucaTAX。在 28 天时,85/15H 的内膜炎症评分高于对照支架,但这种影响在后期时间点消失。

结论

通过选择合适的紫杉醇洗脱动力学,可以开发出一种生物可吸收的镁支架,其在猪冠状动脉模型中的疗效和愈合特征与已建立的紫杉醇洗脱永久性金属支架相当。

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