eG Coated Stents Exhibit Enhanced Endothelial Wound Healing Characteristics

Abstract

Purpose Despite their widespread use, a significant fraction of coronary stents suffer from in-stent restenosis and stent thrombosis. Stent deployment induces extensive injury to the vascular endothelium. Rapid endothelial wound closure is essential for the success of a stenting procedure. A recent study has demonstrated that the BuMA Supreme® sirolimus-eluting stent exhibits particularly attractive strut coverage characteristics. A unique feature of this stent is the presence of a thin brush layer of poly-butyl methacrylate (PBMA), covalently bonded to the stent’s cobalt-chromium frame via electro-grafting (eG™). The present study aimed to determine whether the PBMA coating has an effect on endothelial cell wound healing and stent strut coverage. Methods We used an in vitro coronary artery model whose wall consisted of an annular collagen hydrogel and whose luminal surface was lined with a monolayer of endothelial cells. Mechanical wounding of the endothelial lining was preformed prior to deployment of a bare cobalt-chromium stent either with or without the PBMA layer. The migration of fluorescently labeled endothelial cells was monitored automatically over a period of 48 h to determine endothelial wound healing rates. Results Quantitative assessment of endothelial wound healing rates within the simulated arterial model is achievable using automated image analysis. Wound healing is significantly faster (44% faster at 48 h) for stents with the PBMA eG Coating™ compared to bare metal stents. Conclusion The PBMA eG Coating™ has the effect of promoting endothelial wound healing. Future studies will focus on elucidating the mechanistic basis of this observation.

Angiography-derived physiology guidance vs usual care in an All-comers PCI population treated with the healing-targeted supreme stent and Ticagrelor monotherapy: PIONEER IV trial design

“…The e G base layer functions as a protective layer to ensure superior polymer integrity and attachment that prevents fractures, delamination and peeling ( Figure 1 D), and has the effect of promoting endothelial wound healing, although the biological mechanism involved in this enhanced endothelialization is not elucidated ( Figure 1 E). 20 The HT Supreme showed rapid good endothelial cell binding in a rabbit model ( Figure 1 F, G). 21 The abundant presence of VE-cadherin and protein-120, visualized by immunostaining, demonstrated the quality and robustness of the endothelial interconnection, and the low level of staining by Evans Blue dye when a vessel stented with HT Supreme was compared to Xience Expedition, indicates less permeability, and a better endothelial barrier.…”