Induced Human-like Coronary Stenosis in Hypercholesterolemic PCSK9 Minipigs

Translational models for obstructive coronary artery disease are lacking. We aimed to develop a porcine model for obstructive coronary stenosis induced by bioresorbable stent (BRS) implantation in hypercholesterolemic proprotein convertase subtilisin/kexin-9 (PCSK9) minipigs. Fifteen hypercholesterolemic PCSK9 minipigs were randomized to percutaneous coronary intervention with Magmaris, Absorb or Desolve BRS. Optical coherence tomography (OCT) scans were performed at baseline and 6-months followed by histology. Matched OCT analysis showed minimal lumen area decreased from 7.62 ± 1.54 mm² at baseline to 2.12 ± 0.92 mm² at follow-up in the Magmaris group, from 6.99 ± 1.49 mm² to 3.07 ± 1.52 mm² in the Absorb group, and from 6.05 ± 1.11 mm² to 2.65 ± 0.93 mm² in the Desolve group. Histologic examination revealed advanced human-like stenosis. BRS implantation in hypercholesterolemic PCSK9 minipigs induced human-like stenoses and may serve as a feasible preclinical model for obstructive coronary artery disease.