Related Experiment Video
Updated: Apr 8, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Serial changes of coronary endothelial function and arterial healing after paclitaxel-eluting stent implantation
Yoshiaki Mitsutake1, Takafumi Ueno2, Fumiaki Ikeno3
1Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan. mitsutake_yoshiaki@kurume-u.ac.jp.
Insights
First-generation paclitaxel-eluting stents (PES) may cause long-term endothelial dysfunction and delayed healing. While some vascular function improved over 24 months, issues like poor stent healing and thrombus presence persisted in some patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomaterials Science
Background:
- First-generation drug-eluting stents, specifically paclitaxel-eluting stents (PES), have been linked to coronary endothelial dysfunction and delayed arterial healing.
- Long-term persistence of these issues after PES implantation remains incompletely understood.
Purpose of the Study:
- To evaluate serial changes in endothelial function and intra-stent healing over extended periods following paclitaxel-eluting stent implantation.
Main Methods:
- Eight patients with stable effort angina underwent assessment at 9 months (1st follow-up) and over 24 months (2nd follow-up) after PES implantation.
- Endothelial function was assessed via intracoronary acetylcholine infusion, measuring vascular responses.
- Intra-stent condition was evaluated using angioscopy, assessing neointimal coverage, yellow intima, and in-stent thrombus.
Main Results:
- Vascular responses proximal to the stent showed significant improvement at 2nd follow-up compared to the 1st (p=0.04), but distal responses did not differ (p=0.19).
- Angioscopic evaluation revealed comparable neointimal coverage between follow-ups (average coverage grade 0.9 vs. 1.3, p=0.20).
- Incidence of yellow intima (50% vs. 37.5%, p=1.0) and in-stent thrombus (75% vs. 50%, p=0.61) did not significantly change between assessments.
Conclusions:
- While endothelial dysfunction and delayed healing associated with paclitaxel-eluting stents may gradually attenuate, these complications can persist beyond 24 months in a subset of patients.
- These findings highlight the potential for long-term adverse effects of early-generation DES, necessitating continued monitoring and research into newer stent technologies.
Abstract:
Several studies have shown coronary endothelial dysfunction and delayed arterial healing associated with first-generation drug-eluting stents. However, it remains unclear whether those issues persist for a longer term. We thus evaluated serial changes in endothelial function and intra-stent condition after paclitaxel-eluting stents (PES) implantation. Eight patients with stable effort angina were assessed at 9 and over 24 months (1st and 2nd follow-up) after PES implantation. Endothelial function was evaluated with intracoronary infusion of acetylcholine (Ach). Vascular responses were quantitatively measured. Intra-stent condition was evaluated using angioscopy. We assessed (1) the degree of neointimal coverage over the stent (grade 0: no coverage to grade 3: full coverage); (2) presence of yellow intima inside the stent, and (3) existence of in-stent thrombus. Vasomotions proximal to the stent at 2nd follow-up significantly improved compared with 1st follow-up (p = 0.04), whereas vascular responses at the distal segment did not differ between 1st and 2nd follow-up (p = 0.19). From the angioscopic study, the average of coverage grading was comparable between the 2 points (0.9 ± 0.8 vs. 1.3 ± 1.0, p = 0.20). In addition, the incidence of yellow intima and in-stent thrombus did not differ between 1st and 2nd follow-up (yellow intima; 50 vs. 37.5 %, p = 1.0, thrombus; 75 vs. 50 %, p = 0.61). Endothelial dysfunction and delayed healing with PES could attenuate gradually, but these issues may persist over 24 months in some patients.
