Novel Polymer-Free Everolimus-Eluting Stent Fabricated using Femtosecond Laser Improves Re-endothelialization and Anti-inflammation

Bae, In-Ho; Cho, Jeong Gwan; Lim, Kyung Seob; Park, Dae Sung; Shim, Jae Won; Park, Jun-Kyu; Oh, Kyoung-Hwan; Jin, Mi rim; Sim, Doo Sun

doi:10.1038/s41598-018-25629-9

Cited by 16 publications

(12 citation statements)

References 43 publications

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“…Studies have identified stent design variables, such as polymer coatings, drugs, drug release kinetics and strut thickness that affect reendothelialization [54][55][56][57]. Although the understanding that thicker stent strut dimensions are associated with a greater risk of thrombosis, a mechanism for how flow and the stent strut thickness and geometry affect endothelialization has not been established [58].…”

Section: Discussionmentioning

confidence: 99%

Stent strut streamlining and thickness reduction promote endothelialization

Nguyen

Smith

Jiménez

2021

J. R. Soc. Interface.

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Stent thrombosis (ST) carries a high risk of myocardial infarction and death. Lack of endothelial coverage is an important prognostic indicator of ST after stenting. While stent strut thickness is a critical factor in ST, a mechanistic understanding of its effect is limited and the role of haemodynamics is unclear. Endothelialization was tested using a wound-healing assay and five different stent strut models ranging in height between 50 and 150 µm for circular arc (CA) and rectangular (RT) geometries and a control without struts. Under static conditions, all stent strut surfaces were completely endothelialized. Reversing pulsatile disturbed flow caused full endothelialization, except for the stent strut surfaces of the 100 and 150 µm RT geometries, while fully antegrade pulsatile undisturbed flow with a higher mean wall shear stress caused only the control and the 50 µm CA geometries to be fully endothelialized. Modest streamlining and decrease in height of the stent struts improved endothelial coverage of the peri-strut and stent strut surfaces in a haemodynamics dependent manner. This study highlights the impact of the stent strut height (thickness) and geometry (shape) on the local haemodynamics, modulating reendothelialization after stenting, an important factor in reducing the risk of stent thrombosis.

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Section: Discussionmentioning

confidence: 99%

Stent strut streamlining and thickness reduction promote endothelialization

Nguyen

Smith

Jiménez

2021

J. R. Soc. Interface.

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“…Previously, we have reported that the formation of micropores on the surface of medical devices can have a positive effect on cells [ 14 ]. Furthermore, it has been reported that surface modification via micropore and patterning can improve the function of the metal as an implanted material by controlling the amount of drug in it [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cellular response and drug delivery efficacy of nanoporous stainless steel material

et al. 2021

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Objective Various surface modification techniques that can further improve the function and usability of stainless steel as a medical device have been reported. In the present study, the physical and biological properties of nanoporous stainless steel as well as its usefulness for drug delivery were assessed. Methods The specimen was prepared with a circular disk shape (15 mm in diameter and 1 mm in thickness). The disk was subjected to electropolishing at a constant voltage of 20 V and 10 A for 10 min in an acidic environment (50% H2SO4). Everolimus (EVL) was used as a testing drug for drug-loading capacity of the material surface and release kinetics. The physiobiological properties of the material were assessed using platelet adhesion, and smooth muscle cell (SMC) adhesion, migration, and proliferation assays. Results The surface roughness of the postpolishing group was greater than that of the nonpolishing group. Platelet adhesion and SMC adhesion and migration were inhibited in the postpolishing group compared to those in the prepolishing group. In the postpolishing group, the total amount of EVL on the surface (i.e., drug storage rate) was higher and the drug release rate was lower, with half the amount of the EVL released within 4 days compared with only 1 day for that of the prepolishing group. Conclusion Taken together, this stainless steel with a nanoporous surface could be used as a medical device for controlling cellular responses and carrying drugs.

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“…Therapy against oxidative stress is the promising strategy for treatment of artery stent-induced restenosis [18]. The clinical researches demonstrate that the inflammatory response plays a key role in the artery neointimal hyperplasia and coronary instent restenosis in the patients with coronary heart disease after coronary stent implantation [19].…”

Section: Discussionmentioning

confidence: 99%

“…The study shows that the long stent implantations increase oxidative stress and inflammatory response. The oxidative stress and inflammatory response play the important roles in development of neointimal hyperplasia and instent restenosis in the patients after coronary stent implantations [18,19]. ACR plays a crucial role in the progression of atherosclerosis through the inflammatory response and oxidative stress [1,20].…”

Section: Oxidative Medicine and Cellular Longevitymentioning

confidence: 99%

Complex Coronary Instent Chronic Total Occlusion Lesions: Oxidative Stress, Inflammation, and Coronary Stent Lengths

Guo

Chen

et al. 2021

Oxidative Medicine and Cellular Longevity

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The oxidative stress and inflammation played the key roles in the development of atherosclerotic coronary plaques. However, the relationships between pro/antioxidant, pro/anti-inflammatory status, and complex coronary instent chronic total occlusion lesions were not clear in the elderly patients with very long stent implantations. We tried to evaluate the roles of pro/antioxidant and pro/anti-inflammatory biomarkers in the diagnosis of complex reocclusion lesions in elderly patients after coronary stenting. We evaluated the expression levels of acrolein (ACR), malondialdehyde (MDA), high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), superoxide dismutase 3 (SOD3), paraoxonase-1 (PON-1), endothelial nitric oxide synthase (eNOS), and stromal cell-derived factor-1α (SDF-1α) in the elderly patients with very long stent implantations and complex reocclusion lesions. Levels of ACR, MDA, hs-CRP, and TNF-α were remarkably increased ( P < 0.001 ), and levels of SOD3, PON-1, eNOS, and SDF-1α were decreased significantly ( P < 0.001 ) in the elderly patients with very long stents and complex reocclusion lesions. The prooxidant and proinflammatory biomarkers were remarkably increased, as well as antioxidant and anti-inflammatory biomarkers were decreased significantly in the elderly patients with very long stent implantations and complex reocclusion lesions after coronary stenting. In conclusion, these findings indicated that the imbalance between prooxidant/proinflammatory and antioxidant/anti-inflammatory status was associated with complex reocclusion lesions, suggesting that oxidative stress and inflammation played the key roles in progression of complex reocclusion lesions in the elderly patients with very long stent implantations.

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Novel Polymer-Free Everolimus-Eluting Stent Fabricated using Femtosecond Laser Improves Re-endothelialization and Anti-inflammation

Cited by 16 publications

References 43 publications

Stent strut streamlining and thickness reduction promote endothelialization

Stent strut streamlining and thickness reduction promote endothelialization

Evaluation of cellular response and drug delivery efficacy of nanoporous stainless steel material

Complex Coronary Instent Chronic Total Occlusion Lesions: Oxidative Stress, Inflammation, and Coronary Stent Lengths

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