Abstract 15993: The Nonpolymeric Ciglitazone-Eluting Stent is Superior to the Xience V Stent in a Rabbit Iliacal Artery Model: An Experimental Study Using Optical Coherence Tomography
Background: Non-polymeric local drug delivery might improve safety and efficacy of newer DES. We investigated ciglitazone, a peroxisome proliferator activated receptor-gamma agonist as a novel stent coating.
Methods: Non-polymeric ciglitazone-eluting stents (CES) were produced by coating bare metal stents (2.5x12 mm microporous Yukon Choice, Translumina) with ciglitazone at a drug load of 39 mcg/mm stent length. Commercially available everolimus-eluting stents (EES: 2.5x12 mm Xience V, Abbott Vascular) were us as a comparator. Thirteen NZW rabbits, fed with high cholesterol diet, underwent DES implantation in both common iliac arteries (left: CES, right: EES). Stents were imaged in vivo using optical coherence tomography and postmortem by Elastica-van-Gieson staining after 28 days in 3 animals and after 90 days in 10 animals. A comprehensive algorithm of quantitative OCT assessment of neointimal growth was implemented and applied sequentially to different stent segments (Figure). Four rabbits were euthanized 7 days after stent implantation for evaluation of stent endothelialization by post mortem confocal microscopy using CD 31+ and thrombomodulin staining. For each stent strut the coverage of CD31+ endothelial cells was visually estimated (Figure).
Results: Endothelial coverage was completed in both stent groups (uncovered struts: 0.4 ± 0.6% for EES, and 1.6 ± 3.6% for CES; n.s.). The relative in-stent proliferation area (S_PA%) was significantly smaller in CES compared to EES (25±10% vs. 35±11%, p<0.01) (Figure). Seven days after implantation the CES showed sufficient endothelial coverage of approximately 80 % above and between the struts at confocal microscopy analysis (Figure).
Conclusion: In this animal model the novel non-polymeric ciglitazone-eluting stent was superior to the established Xience V stent and therefore deserves further development and evaluation.
- © 2012 by American Heart Association, Inc.