MedStar Washington Hospital Center, Washington, DC, USA.
EuroIntervention. 2017 Jul 20;13(4):440-449. doi: 10.4244/EIJ-D-16-00915.
The second-generation drug-eluting absorbable magnesium scaffold Magmaris, recently introduced for the treatment of obstructive coronary atherosclerotic lesions, suggests a good safety profile, but preclinical assessment is important for predicting clinical performance. The aim of the present study was to assess subacute and long-term safety as well as pharmacokinetic properties of the Magmaris compared with a current-generation metallic DES and an approved BRS in porcine and rabbit animal models.
Ninety Magmaris scaffolds were implanted into non-diseased porcine and rabbit models. A bioresorbable vascular scaffold (Absorb) and a permanent drug-eluting stent (XIENCE Xpedition) served as controls. Scanning electron microscopy showed increased endothelialisation and decreased thrombus formation at three and 28 days in the Magmaris group compared with the Absorb group. In the XIENCE group, inflammation exceeded the level in the Magmaris group at 365 and 730 days. Neointimal growth was greater in the Magmaris group than in the XIENCE group. Late lumen loss decreased over time in both groups. Optical coherence tomography (OCT) showed stable luminal dimensions in both the Magmaris and XIENCE groups. Pharmacokinetic studies demonstrated a retarded elution profile in the Magmaris group with 69.4% of sirolimus released at 90 days.
Preclinical results suggest that the Magmaris has a favourable safety profile with advanced healing relative to benchmark, low acute thrombogenicity, and absence of excessive lumen loss up to two years. These results support clinical application of Magmaris for human use.
第二代药物洗脱可吸收镁支架 Magmaris 最近被引入用于治疗阻塞性冠状动脉粥样硬化病变,其安全性似乎较好,但临床前评估对于预测临床性能很重要。本研究旨在评估 Magmaris 与当前一代金属药物洗脱支架(DES)和已批准的生物可吸收支架(BRS)在猪和兔动物模型中的亚急性和长期安全性以及药代动力学特性。
90 个 Magmaris 支架被植入非病变猪和兔模型中。生物可吸收血管支架(Absorb)和永久性药物洗脱支架(XIENCE Xpedition)作为对照。扫描电子显微镜显示,与 Absorb 组相比,Magmaris 组在 3 天和 28 天时有更多的内皮化和更少的血栓形成。在 XIENCE 组中,炎症在 365 天和 730 天超过了 Magmaris 组的水平。Magmaris 组的新生内膜生长大于 XIENCE 组。两组的晚期管腔丢失随时间减少。光学相干断层扫描(OCT)显示 Magmaris 和 XIENCE 两组的管腔尺寸均稳定。药代动力学研究表明,Magmaris 组的洗脱曲线较缓,90 天时释放了 69.4%的西罗莫司。
临床前结果表明,Magmaris 具有良好的安全性,相对于基准具有先进的愈合效果、较低的急性血栓形成倾向和长达两年的管腔丢失不增加。这些结果支持 Magmaris 在人体中的临床应用。