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In vitro thrombogenicity of drug-eluting and bare metal stents
Tullio Palmerini1, Chiara Barozzi2, Luciana Tomasi2
1Polo Cardio-Toraco Vascolare, Policlinico S. Orsola, Bologna, Italy.
Insights
Xience drug-eluting stents (DES) showed the least thrombus formation in vitro compared to other DES and bare-metal stents (BMS). A synergistic effect between the fluoropolymer and drug contributed to Xience
Area of Science:
- Cardiovascular research
- Biomaterials science
- Medical device engineering
Background:
- Drug-eluting stents (DES) and bare-metal stents (BMS) are used to treat coronary artery disease.
- Thrombogenicity of different stent types is a critical factor in clinical outcomes.
- In vitro models are essential for evaluating stent performance before clinical trials.
Purpose of the Study:
- To investigate and compare the thrombogenicity of various DES and BMS.
- To evaluate the impact of stent material and drug elution on thrombus formation.
- To identify stent designs with reduced thrombotic potential.
Main Methods:
- An in vitro stent perfusion system was utilized.
- Blood from healthy volunteers was perfused through silicone tubes containing deployed stents.
- 125I-fibrinogen was used to quantify stent surface-induced thrombus deposition.
Main Results:
- Xience DES demonstrated the lowest thrombus formation compared to Resolute, Biomatrix, and Vision DES.
- A significant reduction in thrombus was observed for Xience compared to Vision (50 ng vs. 560 ng).
- Fluoropolymer-coated BMS showed a 3-fold reduction in thrombus compared to Vision DES but a 7-fold increase compared to Xience DES. Xience also showed greater albumin absorption than BMS.
Conclusions:
- Xience DES exhibited the lowest in vitro thrombogenicity among the tested stents.
- A synergistic effect between the stent's fluoropolymer coating and its drug elution was observed.
- These findings suggest Xience may offer improved safety profiles regarding thrombotic events.
Aims:
We sought to investigate the thrombogenicity of different DES and BMS in an in vitro system of stent perfusion.
Material And Methods:
The experimental model consisted of a peristaltic pump connected to 4 parallel silicone tubes in which different stents were deployed. Blood was drawn from healthy volunteers and the amount of stent surfaced-induced thrombus deposition was determined using 125I-fibrinogen.
Results:
Compared to Resolute, Biomatrix and Vision, Xience was associated with the lowest amount of stent surface-induced thrombus formation, with a significant difference compared to Vision (125I-fibrinogen median value deposition [IQ range]: 50 ng [25-98] versus 560 ng [320-1520], respectively, p < 0.05), but not to other DES. In the second set of experiments Fluoropolymer-coated BMS not eluting drug was associated with a significant 3-fold reduction in 125I-fibrinogen deposition (245 ng [80-300]) compared to Vision (625 ng [320-760], p < 0.05), but a 7-fold increase compared to Xience (35 ng [20-60], p < 0.05). Finally Xience was associated with a significantly greater absorption of albumin compared to BMS.
Conclusions:
In an in vitro system of stent perfusion, Xience was associated with the lowest amount of stent surface-induced thrombus formation compared with Resolute, Biomatrix and Vision, with a noted synergistic effect between the fluoropolymer and the drug.
