Effects of gold coating of coronary stents on neointimal proliferation following stent implantation

Dahl, Julian; Haager, Philipp K.; Grube, Eberhard; Groß, Michael; Beythien, C.; Kromer, Eckhard P.; Cattelaens, N.; Hamm, Christian W.; Hoffmann, Rainer; Reineke, Thorsten; Klues, Heinrich G.

doi:10.1016/s0002-9149(02)02188-4

Cited by 52 publications

(25 citation statements)

References 14 publications

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“…In addition, placement of gold-coated stents was associated with a pattern of more diffuse restenosis. Later, results from two other randomized trials showed and exaggerated neointimal hyperplasia and increased risk of restenosis with gold-coated stents [14,20]. Similar findings were more recently reported from another study which used a stent with a gold plating different to those tested in previous studies [15].…”

Section: Discussionsupporting

confidence: 61%

Sustained increased risk of adverse cardiac events over 5 years after implantation of gold‐coated coronary stents

Pache

Dibra

Schaut

et al. 2006

Cathet Cardio Intervent

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Section: Discussionsupporting

confidence: 61%

Sustained increased risk of adverse cardiac events over 5 years after implantation of gold‐coated coronary stents

Pache

Dibra

Schaut

et al. 2006

Cathet Cardio Intervent

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“…von Birgelen et al (21) found a similar correlation in the coronary circulation after oversized self-expanding stents were deployed in coronary arteries. Other factors important in coronary stent design, such as strut thickness or the type of metallic alloy, may also affect the amount of carotid neointima (22,23). However, the present study was not large enough to assess for variable neointimal proliferation between different stent designs.…”

Section: Discussionmentioning

confidence: 85%

Mechanisms and Predictors of Carotid Artery Stent Restenosis

Clark

Lessio

O’Donoghue

et al. 2006

Journal of the American College of Cardiology

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“…Results of angiographic variables such as binary restenosis, luminal late loss, and percent diameter stenosis also showed a worse outcome, suggesting that gold-coated stents actually increase the risk of restenosis when used in complex lesions (Table 4). Smaller clinical trials by vom Dahl et al 49 and Park et al 50 that enrolled a total of 420 patients have published similar results, demonstrating a worse outcome in the gold-coated stent arms of the trials. The authors of these studies concluded that gold-coated stents appear to exaggerate the proliferative response after PCI when implanted in complex lesions (Table 4).…”

Section: Stents Coated With Biocompatible Materialsmentioning

confidence: 79%

Coated Stents for the Prevention of Restenosis: Part II

2002

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T his is the second part of a 2-part article that reviews the literature on coated stents and their effects on in-stent restenosis after percutaneous coronary intervention (PCI). Part I of this review discussed the pathophysiology of in-stent restenosis, specific stent coatings, and animal studies investigating coated stents. Part II discusses nonrandomized studies and clinical trials in humans. Studies in humans have examined stents coated with biocompatible materials and drug-eluting stents. Complications and controversies associated with this new technology are also addressed. Human StudiesThe risk of developing in-stent restenosis is related to a variety of factors, both clinical and procedural. [1][2][3][4][5][6][7] On the basis of these risk factors, patients enrolled in both nonrandomized studies and clinical trials have been classified as having a high, intermediate, or low risk of restenosis. Therefore, the binary restenosis rates (Ͼ50% diameter stenosis angiographically) and major adverse cardiac event (MACE) rates in human studies vary greatly depending on the overall risk profile of patients enrolled in these studies. Non-Randomized Studies Stents Coated with Biocompatible MaterialsThe biocompatibility of stents coated with several materials, including carbon, gold, silicon carbide, and phosphorylcholine, has been investigated in humans. The Carbostent (Sorin Biomedica Cardio) is a metal stent coated with a carbon film that is thought to be less thrombogenic than uncoated steel stents. 8 Antoniucci et al 9 investigated the long-term biocompatibility of the Carbostent in a group of 112 patients with an intermediate risk of developing restenosis. Six-month follow-up revealed low MACE and restenosis rates of 12% and 11%, respectively. A second study in another group of 112 patients at high risk for restenosis resulted in a MACE rate of 20% and a binary restenosis rate of 25% by 6 months. 10 These results suggest that the Carbostent is well tolerated in vivo and possibly inhibits neointimal hyperplasia, especially in high-risk patients (Table 1).Gold has been touted as a biocompatible material and has been thought to be ideal for coating coronary stents because of its radio-opaque properties. 1 Two studies evaluating the biocompatibility of gold-coated stents suggested equivalency with uncoated steel stents. 11,12 However, two other studies concluded that these stents may increase neointimal hyperplasia compared with uncoated stents, although patients at a higher risk for restenosis were enrolled. 13,14 Follow-up angiography at 6 months demonstrated a relatively high lumen late loss (postintervention minimum luminal diameter minus the minimum luminal diameter at follow-up) and diameter stenosis in both studies (Table 1). Overall, there have been conflicting results in observational studies examining goldcoated stents, and the restenosis rates seem to be no better than those obtained with uncoated steel stents.Silicon carbide is an inert semiconductor that can be coated onto prosthetic surfaces and has be...

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Effects of gold coating of coronary stents on neointimal proliferation following stent implantation

Cited by 52 publications

References 14 publications

Sustained increased risk of adverse cardiac events over 5 years after implantation of gold‐coated coronary stents

Sustained increased risk of adverse cardiac events over 5 years after implantation of gold‐coated coronary stents

Mechanisms and Predictors of Carotid Artery Stent Restenosis

Coated Stents for the Prevention of Restenosis: Part II

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