Abstract 15944: Comparative Vascular Responses After Implantation of Everolimus-Eluting Bioresorbable Vascular Scaffolds in a Diabetic Atherosclerotic Porcine Coronary Arterial Model: A Longitudinal Histology Study
Background: The outcome of patients with diabetes mellitus (DM) after revascularization is usually worse compared to non-DM (NDM) patients. Vascular tissue alterations following implantation of everolimus-eluting bioresorbable vascular scaffold (Absorb BVS) have been reported in a healthy swine coronary model. However, it is not known how DM and atherosclerosis affect this response. We therefore investigated the vascular response to Absorb BVS in a porcine coronary model of streptozotocin (STZ)-induced DM and a high cholesterol diet.
Method: Of 15 farm-bred swine, 8 swine received 140 mg/kg STZ to induce DM. Two weeks after stable induction of DM, a high cholesterol diet was introduced (8 DM, 7 NDM). Nine months later, Absorb BVS (3.0x18 mm) were randomly implanted in the coronary arteries under guidance of quantitative coronary angiography (QCA). Histological analysis was performed on 5 scaffolds at 3 months (DM n=3, NDM n=2) and 10 scaffolds at 6months (DM n=5, NDM n=5). Analyses included neointimal thickness (NIT), injury-, inflammation-, and calcification-score, and quantification of fat area. We used a two-way ANOVA for follow up time and disease type, and Pearson’s correlation analysis for continuous values. Multiple regression analysis was used to clarify whether these were independent determinants of NIT.
Results: NIT, injury-, inflammation-, and calcification-scores did not differ between DM and NDM or 3 and 6 mo follow-up. NIT had a negative correlation with QCA based pre implantation diameter, (r=-0.48, p=0.048), and positive correlations with injury- (r=0.50, p=0.04), inflammation- (r=0.57, p=0.02), and calcification- (r=0.56, p=0.02) scores. Stepwise regression analysis clarified that injury score was the independent predictor of NIT (β= 0.50, p= 0.04) and inflammation score (β=0.68, p=0.002), Injury score was determined by QCA based pre arterial diameter (β= -0.50, p=0.046). This was likely caused by availability of only one scaffold size. NIT and injury were not affected by presence of DM or follow up duration.
Conclusion: The vascular response to Absorb BVS was similar in DM and NDM swine , although placement warrants proper sizing.
- © 2013 by American Heart Association, Inc.