scholarly journals eG Coated Stents Exhibit Enhanced Endothelial Wound Healing Characteristics

2021 ◽  
Author(s):  
Belen Rodriguez-Garcia ◽  
Christophe Bureau ◽  
Abdul I. Barakat
Keyword(s):  
Wound Healing ◽  
Endothelial Cells ◽  
Bare Metal Stents ◽  
Automated Image Analysis ◽  
Butyl Methacrylate ◽  
Metal Stents ◽  
Cobalt Chromium ◽  
Endothelial Lining ◽  
Stent Deployment ◽  
Endothelial Wound Healing

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.

Abstract 2553: Novel Cobalt-Chromium Ultra-Thin Strut Stent: Feasibility, Vascular Compatibility, and Safety Evaluation in Porcine Coronary Arteries

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Refat Jabara ◽  
Sarah Geva ◽  
Dongming Hou ◽  
Jinsheng Li ◽  
Nicolas Chronos ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Safety Evaluation ◽  
Bare Metal Stents ◽  
Quantitative Coronary Angiography ◽  
Metal Stents ◽  
Attractive Alternative ◽  
Neointima Formation ◽  
Cobalt Chromium ◽  
Cobalt Alloy ◽  
Strut Thickness

Stent-strut thickness is related to in-stent restenosis. Therefore, modern bare-metal stents (BMS) with lower strut thickness are in development. We sought to evaluate a new ‘third-generation’ BMS comprising an ultra-thin-strut, cobalt-chromium platform with fixed geometry and uniform cell sizes, in a clinically relevant animal model. 36 BMS of two types were implanted in pig coronaries using quantitative coronary angiography (QCA) to optimize stent apposition: a commercially available cobalt alloy thin-strut stent (91μm) as control (n=18), and an ultra-thin-strut (65μm) cobalt-chromium stent (Protea CoCr; n=18). Animals underwent angiographic restudy and termination 1-wk and 1-mo post-implant for coronary artery histology. In addition, 12 overlapping Protea CoCr stents were analyzed at 1-mo. All stents deployed without difficulties. Thin neointima and mild inflammation was seen in both groups at 1-wk. For 1-mo, QCA % diameter stenosis was significantly less for Protea CoCr (2±5% vs. 17±16%, p=0.032). By histomorphometry, intima thickness (0.11±0.05mm vs. 0.23±0.11mm, p=0.003) and % area stenosis (19±1% vs. 32±11%, respectively, p=0.004) were also significantly lower for Protea CoCr. The strut injury score was low and similar between the two groups. QCA % stenosis; intima thickness; and % area stenosis of overlapping Protea CoCr were 3±3%, 0.13±0.02mm, and 22±4%, respectively. Stable fibrocellular neointimal incorporation of all stents including overlapped Protea CoCr, with complete endothelialization and minimal inflammation, was seen at one month. Protea CoCr showed favorable arterial response with significant reduction of neointima formation compared to a commercial cobalt alloy BMS, one month post implant in pig coronary arteries. This ultra-thin-strut stent platform therefore appears to be a suitable and attractive alternative to current BMS. Combining the lower levels of neointima formation, fixed geometry, and uniform cell size, the Protea CoCr may be a preferred platform for next-generation drug-eluting stents.

scholarly journals The outcomes of patients with very small coronary artery disease treated with thin strut cobalt chromium bare metal stents: an observational study

SpringerPlus ◽  
2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Dzafir Ismail ◽  
Wan Azman Wan Ahmad ◽  
Matthias Leschke ◽  
Matthias Waliszewski ◽  
Michael Boxberger ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Observational Study ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Cobalt Chromium ◽  
Artery Disease

Beta Titanium Alloys with Very High Ductility Induced by Complex Deformation Mechanisms: a New Material Perspective for Coronary Stent Applications

2011 ◽  
Vol 172-174 ◽  
pp. 129-134 ◽  
Author(s):  
Fan Sun ◽  
Thierry Gloriant ◽  
Philippe Vermaut ◽  
Pascal Jacques ◽  
Frédéric Prima
Keyword(s):  
Stainless Steel ◽  
Titanium Alloys ◽  
Design Method ◽  
Bare Metal Stents ◽  
Mechanical Twinning ◽  
Metal Stents ◽  
High Ductility ◽  
Stent Deployment ◽  
Major Drawback ◽  
Complex Deformation

The increased use of metallic biomaterials in contact with blood e.g. for application as coronary stents is steadily resulting in the development of new biomaterials. Conventional bare-metal stents made by stainless steel were reported on adverse reactions against human body and are gradually replaced by coated stainless steel. The new generation of stent requires fundamental improvements at the materials point of view. Although titanium and classical Ti-alloys display superior biocompatibility compared to other metallic materials (stainless steels, Co-Cr), the major drawback of their relatively low ductility (typically 15%-25% of elongation) seriously limits their applications as cardiovascular stents, where large ductility is basically required during the stent deployment procedure and long-term service. In this paper, new titanium alloys with high ductility, a binary Ti-12Mo (wt%) and a ternary Ti-9Mo-6W (wt%) were designed by using a chemical formulation strategy based on the electronic design method called “the d-electron alloy design method”. Both alloys were synthesized and thermo-mechanically treated into beta-metastable state. In tensile tests, both alloys exhibited outstanding ductility of 43% and 46% in total elongation at room temperature, which is almost two times greater than the normal value shown with classical titanium alloys. Optical microscopy and detailed TEM observations on the deformed specimens revealed a complex deformation mechanism, involving {332}<113> mechanical twinning, stress induced plate shaped omega phase and stress induced martensitic (SIM) transformation β-α’’.

Abstract 13522: Vascular Healing in Drug-Eluting Stents: Differential Response of Limus-Eluting Stents in a Preclinical Model of Stent Implantation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kazuko Tajiri ◽  
Akira Sato ◽  
Tomoya Hoshi ◽  
Taizo Kimura ◽  
Yoshihiro Seo ◽  
...  
Keyword(s):  
Gene Expression ◽  
Growth Factors ◽  
Stent Implantation ◽  
Late Phase ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Preclinical Model ◽  
Cobalt Chromium ◽  
Angiogenic Growth Factors ◽  
The Difference

Introduction: Recently, several clinical studies suggest that second-generation cobalt-chromium everolimus-eluting stents (CoCr-EES) lead to more favorable vascular healing than first-generation sirolimus-eluting stents (SES). However, it remains unclear the difference of vascular responses between CoCr-EES and SES. Methods: A total of 42 stents (14 bare-metal stents [BMS], 13 CoCr-EES, and 15 SES) were deployed in the iliac arteries of 31 Japanese White rabbits. Qquantitative real-time reverse-transcription polymerase chain reaction (QRT-PCR) analyses of the neointima were performed on days 30 and 90 after the stent implantation. Results: On day 30, the gene expression of the angiogenic growth factors (hepatocyte and basic fibroblast growth factors) and proteoglycans (decorin, biglycan and lumican) were more upregulated in the BMS than in the SES. However, at 90 days after stenting, the gene expression of proteoglycans and collagen was more upregulated in the SES than in the CoCr-EES and BMS. Conclusions: In contrast to CoCr-EES and BMS, SES strongly suppresses the vascular healing-related gene expression in the early phase, and then upregulates it in the late phase. These differences may lead to different clinical outcomes in humans.

scholarly journals Do ultrathin strut bare-metal stents with passive coating improve efficacy in large coronary arteries? Insights from the randomized, multicenter BASKET-PROVE trials

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kim Wadt Hansen ◽  
Raban Jeger ◽  
Rikke Sørensen ◽  
Christoph Kaiser ◽  
Matthias Pfisterer ◽  
...  
Keyword(s):  
Silicon Carbide ◽  
Coronary Arteries ◽  
Cardiac Death ◽  
Proportional Hazards ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Cobalt Chromium ◽  
Stent Type ◽  
Large Coronary Arteries

Abstract Background The new generation thinner-strut silicon carbide (SiC) coated cobalt chromium (CoCr) bare-metal stents (BMS) are designed to accelerate rapid endothelialisation and reduce thrombogenicity when implanted in coronary arteries. However, smaller studies suggest higher rates of symptomatic restenosis in patients receiving the newer generation BMS. We investigated the efficacy of a newer generation ultrathin strut silicon-carbide coated cobalt-chromium (CoCr) BMS (SCC-BMS) as compared to an older thin-strut uncoated CoCr BMS (UC-BMS) in patients presenting with coronary artery disease requiring stenting of large vessels (≥3.0 mm). Methods All patients randomized to SCC- (n = 761) or UC-BMS (n = 765) in the two BASKET-PROVE trials were included. Design, patients, interventions and follow-up were similar between trials except differing regimens of dual antiplatelet therapy. The primary endpoint was clinically driven target-vessel revascularization within 24 months. Safety endpoints of cardiac death, non-fatal myocardial infarction (MI), and definite/probable stent thrombosis (ST) were also assessed. We used inverse probability weighted proportional hazards Cox regressions adjusting for known confounders. Results Demographics, clinical presentation, and risk factors were comparable between the groups, but patients receiving SCC-BMS underwent less complex procedures. The risk for clinically driven TVR was increased om the SCC-BMS group compared to the UC-BMS group (cumulative incidence, 10.6% vs. 8.4%; adjusted relative hazard [HR], 1.49 [95% CI, 1.05–2.10]). No differences in safety endpoints were detected, cardiac death (1.6% vs. 2.8%; HR, 0.62 [CI, 0.30–1.27]), non-fatal MI (3.2% vs. 2.5%; HR, 1.56 [CI, 0.83–2.91]), and definite/probable ST (0.8% vs. 1.1%; HR, 1.17 [CI, 0.39–3.50]). Differences in strut thickness between the two stents did not explain the association between stent type and clinically driven TVR. Conclusions In patients requiring stenting of large coronary arteries, use of the newer generation SCC-BMS was associated with a higher risk of clinically driven repeat revascularization compared to the UC-BMS with no signs of an offsetting safety benefit.

Treatment of central venous in-stent restenosis with repeat stent deployment in hemodialysis patients

2017 ◽  
Vol 18 (3) ◽  
pp. 214-219 ◽  
Author(s):  
James Ronald ◽  
Bradley Davis ◽  
Carlos J. Guevara ◽  
Waleska M. Pabon-Ramos ◽  
Tony P. Smith ◽  
...  
Keyword(s):  
Bare Metal Stents ◽  
Hemodialysis Patients ◽  
Transluminal Angioplasty ◽  
Primary Patency ◽  
Metal Stents ◽  
Central Vein ◽  
Secondary Patency ◽  
Stent Deployment ◽  
Percutaneous Transluminal ◽  
Stent Stenosis

Purpose To report patency rates for stent deployment for treatment of in-stent stenosis of the central veins of the chest in hemodialysis patients. Materials and Methods A retrospective analysis was performed on 29 patients who underwent 35 secondary percutaneous transluminal stent (PTS) deployments for in-stent stenosis within the central veins that were refractory to angioplasty and ipsilateral to a functioning hemodialysis access (in-stent PTS group). For comparison, patency data were acquired for 47 patients who underwent 78 successful percutaneous transluminal angioplasty (PTA) procedures for in-stent stenosis (in-stent PTA group) and 55 patients who underwent 55 stent deployments within native central vein stenosis refractory to angioplasty (native vein PTS group). Results The 3-, 6-, and 12-month primary lesion patency for the in-stent PTS group was 73%, 57%, and 32%, respectively. The 3-, 6-, and 12-month primary patency for the in-stent PTA group was 70%, 38%, and 17% and for the native vein PTS group was 78%, 57%, and 26%, which were similar to the in-stent PTS group (p = 0.20 and 0.41, respectively). The 3-, 6-, and 12-month secondary access patency was 91%, 73%, and 65% for the in-stent PTS group. Sub-analysis of the in-stent PTS group revealed no difference in primary (p = 0.93) or secondary patency rates (p = 0.27) of bare metal stents (n = 23) compared with stent grafts (n = 12). Conclusions Stent deployment for central vein in-stent stenosis refractory to angioplasty was associated with reasonable patency rates, which were similar to in-stent PTA and native vein PTS.

Expression of synaptopodin in endothelial cells exposed to laminar shear stress and its role in endothelial wound healing

FEBS Letters ◽  
2014 ◽  
Vol 588 (6) ◽  
pp. 1024-1030 ◽  
Author(s):  
Gyeong In Mun ◽  
Soojin Park ◽  
Joachim Kremerskothen ◽  
Yong Chool Boo
Keyword(s):  
Wound Healing ◽  
Endothelial Cells ◽  
Shear Stress ◽  
Laminar Shear Stress ◽  
Endothelial Wound Healing ◽  
Laminar Shear

scholarly journals PRECLINICAL EVALUATION OF THE VASCULAR EFFECTS OF REJUVENATE® COBALT CHROMIUM CORONARY STENT SYSTEM IMPLANTED IN THE PORCINE CORONARY IN STENT RESTENOSIS MODEL

2021 ◽  
Vol 54 (2) ◽  
pp. 132-138
Author(s):  
Murtaza Najabat Ali ◽  
Mariam Mir ◽  
Piotr Buszman
Keyword(s):  
Vascular Tissue ◽  
Bare Metal Stents ◽  
Bare Metal Stent ◽  
Metal Stents ◽  
Bare Metal ◽  
Cobalt Chromium ◽  
Metal Stent ◽  
Stent Patency ◽  
The Mean

Objectives: The main objective of the study was to evaluate the implantation, safety, and vascular tissue effects of REJUVENATE® Cobalt Chromium Bare Metal Stent in the Porcine Coronary Restenosis model at short, mid and long-term follow up. Methodology: A total of 18 REJUVENATE® bare metal stents (CoCr, 95 µm strut thickness) were implanted into the coronary arteries (RCA, LCX and LAD) of the six pigs. Throughout the study period, stent patency, vascular response, percent stenosis, late lumen loss and performance of stent were evaluated by angiography, optical coherence tomography (OCT), and Histopathology (includes both Histopathology and histomorphometry) at 30, 90, and 180 days and compared with the results of control Bare Metal Stent Coflexus®. The mean, variance and standard deviation was analyzed using SPSS software. Results: OCT and QCA analysis demonstrated two cases of binary restenosis at 30 days follow-up and two at 90 days follow-up (33%). The mean area stenosed for Rejuvenate® was 34% as compared to 24% of Coflexus® and at 180 days follow up, it decreased to 21%. The histopathology analysis demonstrated favorable safety with acceptable levels of neointimal formation, with decreased levels of inflammation and complete endothelialization in 180 days. Conclusion: This study proved the potential safety of REJUVENATE® in porcine model and supports that this stent can move forward for the human trials.

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