Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan.
TERUMO Corporation Evaluation Center, Kanagawa, Japan.
PLoS One. 2019 Jan 10;14(1):e0209841. doi: 10.1371/journal.pone.0209841. eCollection 2019.
Current drug-eluting stents have abluminal polymer coating; however, thrombus formation in these compared with that in uniformly coated stents remains controversial. We evaluated thrombus formation and early endothelialization after using abluminal biodegradable polymer-coated sirolimus- (BP-SES), and everolimus-eluting stents (BP-EES) versus a durable polymer-coated everolimus-eluting stent (DP-EES) in an in vivo setting. BP-SES, BP-EES, and DP-EES (n = 6 each) were implanted in coronary arteries of 12 mini-pigs that were then sacrificed after 7 and 10 days. Stents were stained with hematoxylin and eosin, and a combined Verhoeff and Masson trichrome stain. Areas of fibrin deposition were digitally detected and measured with off-line morphometric software. Stents were investigated for re-endothelialization by transmission electron microscopy. At 7 days, histological analysis revealed the lowest area of fibrin deposition in BP-SES (BP-SES vs. BP-EES vs. DP-EES; 0.10 ± 0.06 mm2 vs. 0.15 ± 0.07 mm2 vs. 0.19 ± 0.06 mm2, p = 0.0004). At 10 days, the area of fibrin deposition was significantly greater in DP-EES (0.13 ± 0.04 mm2 vs. 0.14 ± 0.05 mm2 vs. 0.19 ± 0.08 mm2, p = 0.007). Endothelial cells in BP-SES demonstrated a significantly greater number of tight junctions than those in DP-EES according to by transmission electron microscopy for both days (p<0.05). Various parameters, including an inflammatory reaction and neointimal formation, were comparable among the groups at 7 and 10 days. An abluminal biodegradable polymer-coated SES showed the least fibrin deposition and greatest endothelial cell recovery at an early stage following implantation in the coronary arteries of mini-pigs.
目前的药物洗脱支架具有管腔外聚合物涂层；然而，与均匀涂层支架相比，这些支架中的血栓形成仍然存在争议。我们评估了在体内环境中使用管腔外可生物降解聚合物涂层的西罗莫司（BP-SES）和依维莫司洗脱支架（BP-EES）与耐用聚合物涂层的依维莫司洗脱支架（DP-EES）后血栓形成和早期内皮化。将 BP-SES、BP-EES 和 DP-EES（每组 6 个）植入 12 只小型猪的冠状动脉中，然后在 7 天和 10 天后处死。支架用苏木精和伊红染色，并进行 Verhoeff 和 Masson 三色染色。使用脱机形态计量软件数字检测和测量纤维蛋白沉积区域。通过透射电子显微镜研究支架的再内皮化情况。在 7 天时，组织学分析显示 BP-SES 中纤维蛋白沉积的面积最低（BP-SES 与 BP-EES 与 DP-EES；0.10 ± 0.06 mm2 与 0.15 ± 0.07 mm2 与 0.19 ± 0.06 mm2，p = 0.0004）。在 10 天时，DP-EES 中的纤维蛋白沉积面积显著增加（0.13 ± 0.04 mm2 与 0.14 ± 0.05 mm2 与 0.19 ± 0.08 mm2，p = 0.007）。根据透射电子显微镜，在这两天，BP-SES 中的内皮细胞比 DP-EES 中的内皮细胞具有更多的紧密连接（p<0.05）。在 7 天和 10 天，各组之间的炎症反应和新生内膜形成等各种参数无差异。在小型猪冠状动脉内植入后早期，管腔外可生物降解聚合物涂层 SES 显示出最低的纤维蛋白沉积和最大的内皮细胞恢复。
