A novel noble metal stent coating reduces in vitro platelet activation and acute in vivo thrombosis formation: a blinded study

Abstract

Inherent to any stenting procedure is the prescription of dual antiplatelet therapy (DAPT) to reduce the platelet response. Clinical guidelines recommend 6–12 months of DAPT, depending on stent type, clinical picture and patient factors. Our hypothesis is that a nanostructured noble metal coating has the potential to reduce protein deposition and platelet activation. These effects would reduce subsequent thrombo-inflammatory reactions, potentially mitigating the need for an extensive DAPT in the acute phase. Here, a noble metal nanostructure coating on stents is investigated. Twelve pigs underwent endovascular implantation of coated and non-coated stents for paired comparisons in a blinded study design. The non-coated control stent was placed at the contralateral corresponding artery. Volumetric analysis of angiographic data, performed by a treatment blinded assessor, demonstrated a significant thrombus reduction for one of the coatings compared to control. This effect was already seen one hour after implantation. This finding was supported by in vitro data showing a significant reduction of coagulation activation in the coated group. This novel coating shows promise as an implant material addition and could potentially decrease the need for DAPT in the early phases of stent implementation.

Coatings for Cardiovascular Stents—An Up-to-Date Review

“…On the other hand, the documented favorable results prompted the standard of treatment for percutaneous coronary intervention (PCI) to be changed to stent implantation. The use of the initial generation of these devices was often limited by in-stent restenosis, which led to the failure of the current stent or a reintervention using a different stent, regardless of the history of clinical safety and efficacy [16][17][18]. Due to the shortcomings of bare metal stents (BMSs), new stent materials, designs, surface treatments, and coatings have been investigated to enhance the device's functionality and, in particular, to reduce the rate of in-stent restenosis.…”