Vascular healing in drug-eluting stents: differential drug-associated response of limus-eluting stents in a preclinical model of stent implantation

Abstract

Sirolimus and its derivatives have similar effects on endothelial regrowth and neointimal thickening. The observation of greatest fibrin deposition in the experimental EES group indicates that everolimus may affect vascular healing differently.

Safety and Efficacy of New Sirolimus-eluting Stent Models in a Preclinical Study

“…28,39,40 Interestingly, DES-3 showed no significant differences compared with CS, confirming the safety of this device. Likewise, fibrin deposition around the stents was greater in the DES group, which is an indication of the effect of the drug.…”

Comparable vascular response of a new generation sirolimus eluting stents when compared to fluoropolymer everolimus eluting stents in the porcine coronary restenosis model

“…Both DES showed increased fibrin deposition when compared to BMS, which is considered a fingerprint of drug elution and retention in tissue and has been reported previously [4,23]. The inflammatory reaction to implanted stents in this experiment deserves attention and discussion.…”

“…It has been shown that autonomously sirolimus and its derivatives (everolimus, zotarolimus) have similar effects on vascular response and clinical outcomes [4,5], therefore it has been postulated that the polymer and release kinetics were responsible for the negative tissue effect and clinical outcomes. The early generation SES consisted of non-erodible PEVA/PBMA polymers and thick strut profile stent platform which caused anaphylactic and inflammatory reactions, resulting in impaired vessel healing and ultimately adverse thrombotic events [6].…”

Two‐year outcomes after deployment of XIENCE V everolimus‐eluting stents in patients undergoing percutaneous coronary intervention of bifurcation lesions: A report from the SPIRIT V single arm study

“…The Xience V EES is based on a stent platform with very thin stent struts that may minimize aberrations in shear stress that, as observed in prior studies , have been shown to contribute to impaired re‐endothelialization, restenosis and possibly stent thrombosis . An optical coherence tomography (OCT) study has shown more complete stent covered at 9 months after deployment of the Xience V EES compared to SES , while everolimus and sirolimus were shown in an in vivo model to confer similar efficacy with respect to strut coverage at 28 days when the stent platform was controlled, suggesting that the platform may play an important role . Nonetheless, a difference was observed in 2‐year TLR rates in patients who had side‐branch intervention, between those who had ballooning only of the side‐branch, and those whose side‐branches were stented (Fig.…”