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Updated: Jun 23, 2026
Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
Published on: September 14, 2009
Six-month comparison of coronary endothelial dysfunction associated with sirolimus-eluting stent versus
Jin Won Kim1, Soon Yong Suh, Cheol Ung Choi
1Cardiovascular Center, Korea University, Guro Hospital, 97 Gurodong-Gil, Guro-gu, Seoul, Republic of Korea.
Insights
Drug-eluting stents (DES) may cause long-term endothelial dysfunction, particularly in segments distal to the stent. This impaired function, characterized by abnormal vasoconstriction, was observed 6 months post-implantation.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Biology
Background:
- Drug-eluting stents (DES) are associated with delayed vessel healing.
- This delayed healing may lead to impaired endothelial function post-implantation.
Purpose of the Study:
- To investigate the relationship between drug-eluting stent (DES) implantation and endothelial dysfunction.
- To assess endothelial function at 6 months following stenting.
Main Methods:
- Endothelial function was evaluated in 75 patients with DES (sirolimus-eluting stents [SES] and paclitaxel-eluting stents [PES]) and 10 patients with bare-metal stents (BMS).
- Acetylcholine (Ach) and nitrate infusions were used to assess vascular responses in segments proximal and distal to stents, and in a non-stented artery.
- Measurements were taken 6 months after stenting, with antianginal agents withheld for 72 hours prior.
Main Results:
- Greater vasoconstriction to Ach was observed in SES and PES groups compared to BMS and control segments.
- Vasoconstriction was more pronounced in segments distal to DES in both SES and PES groups.
- No significant difference in endothelium-independent vasodilation to nitrate was found between groups.
Conclusions:
- Drug-eluting stents (DES) are associated with abnormal vasoconstriction, indicating local coronary endothelial dysfunction.
- This dysfunction is particularly evident in segments distal to the stent at 6 months post-implantation.
- DES may have a potential long-term adverse effect on coronary endothelial function.
Objectives:
This study was designed to investigate whether endothelial dysfunction is related to drug-eluting stent (DES) implantation at 6 months after stenting.
Background:
Current available DES could delay vessel healing and subsequently impair endothelial function.
Methods:
Endothelial function was estimated at 6-month follow-up in 75 patients (31 men, mean age 62.1 years) with a DES (39 sirolimus-eluting stents [SES], 36 paclitaxel-eluting stents [PES]), and 10 patients with a bare-metal stent (BMS) to the left anterior descending artery, by incremental acetylcholine (Ach) infusion (20 microg/min, 50 microg/min, 100 microg/min) and nitrate (200 microg/min) into the left coronary ostium. Vascular responses were quantitatively measured in arterial segments 5 mm proximal and distal to DES and compared with corresponding segments in the BMS group and midsegments in the left circumflex artery as a reference nonstented artery. All antianginal agents were withheld for at least 72 h before coronary angiography.
Results:
Greater vasoconstriction to Ach was observed in both the SES and PES groups than in the BMS group or control segments of left circumflex artery. Vasoconstriction to Ach was more prominent in arterial segments distal to stents in both SES and PES groups compared with those in the BMS group (p < 0.001). The degree of vasoconstriction to Ach was similar between the SES and PES groups. Endothelium-independent vasodilatation to nitrate did not differ significantly between the study groups.
Conclusions:
Abnormal vasoconstriction to Ach was found in the SES and PES groups, especially in arterial segments distal to DES at 6 months after stenting, which suggests that DES has a potential long-term adverse effect on local coronary endothelial dysfunction.