Endothelial cell recovery between comparator polymer-based drug-eluting stents
Endothelial cell recovery between comparator polymer-based drug-eluting stents
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DOI：
10.1016/j.jacc.2008.04.030
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发表时间：
2008-07-29
影响因子：
24
通讯作者：
Virmani, Renu
中科院分区：
文献类型：
--
作者：
Joner, Michael;Nakazawa, Gaku;Virmani, Renu
目的本研究的目的是评估主要聚合物药物洗脱支架（DES）的内皮覆盖和恢复趋势。S.美国食品和药物管理局（FDA）批准的DES植入冠状动脉表明，晚期支架血栓形成的并发症与不完全的内皮覆盖struts.Methods兔接受西罗莫司洗脱支架（SES），紫杉醇洗脱支架（PES），佐他莫司洗脱支架（ZES），依维莫司洗脱支架（EES）14或28天沿着与MULTI-LINK（ML）视力控制支架。通过对通过正面扫描电子显微镜获得的图像进行形态学分析，测量支柱上方和支柱之间的内皮覆盖率。对血小板-内皮细胞粘附分子（PECAM）-1和血栓调节蛋白（TM）进行双重荧光免疫标记，这两种因子分别参与细胞间接触和血栓形成。在一个单独的分析中，内皮细胞有丝分裂原，血管内皮生长因子（VEGF），也assessed.Results比较DES之间的内皮化的变化率是最显着的在14天，在SES，PES和ZES（= 70%），而没有显着差异，在28天观察到的覆盖率在支柱仍然很差。选择内皮化差的DES显示PECAM-1的表达进一步降低。所有DES显示抗血栓形成辅因子TM的缺失或弱表达。在选择DES的不完全内皮化进一步与增加VEGF分泌和信使核糖核酸水平在14天，提供证据的过渡愈合surface.Conclusions本研究标志着第一个比较分析的内皮覆盖率领先的聚合物DES，支持差异动脉愈合的基础上内皮再生和恢复，与当前一代FDA批准的支架相比，更倾向于更新的设计。
Objectives The purpose of this study was to assess trends in endothelial coverage and recovery among leading polymer-based drug-eluting stents ( DES).Background Autopsy studies of human U. S. Food and Drug Administration (FDA)-approved DES implanted coronary arteries suggest that complications of late stent thrombosis are associated with incomplete endothelial coverage of struts.Methods Rabbits received sirolimus-eluting stents (SES), paclitaxel-eluting stents ( PES), zotarolimus-eluting stents ( ZES), and everolimus-eluting stents ( EES) for 14 or 28 days along with MULTI-LINK ( ML) Vision control stents. Endothelial coverage above and between struts was measured by morphometric analysis of images acquired through en face scanning electron microscopy. Dual fluorescent immunolabeling was performed for platelet-endothelial cell adhesion molecule ( PECAM)-1 and thrombomodulin ( TM), factors involved in cell-to-cell contact and thrombogenicity, respectively. In a separate analysis, the endothelial mitogen, vascular endothelial growth factor ( VEGF), was also assessed.Results Varying rates of endothelialization among comparator DES were most notable at 14 days, where coverage above struts remained poor in SES, PES, and ZES ( = 70%), whereas no significant differences were observed at 28 days. Select DES with poor endothelialization showed a further reduced expression of PECAM-1. All DES showed an absence or weak expression of the antithrombotic cofactor TM. Incomplete endothelialization in select DES was further associated with increased VEGF secretion and messenger ribonucleic acid levels at 14 days, providing evidence of a transitional healing surface.Conclusions The present study marks the first comparator analysis of endothelial coverage in leading polymeric DES, supporting disparities in arterial healing based on endothelial regrowth and recovery, favoring newer designs over the current generation of FDA-approved stents.