Abstract 17080: Development of a Prostacyclin-Agonist Eluting Aortic Stent Graft Enhancing Biological Attachment to the Aortic Wall
Background: Stent graft-related complications, such as endoleak or graft migration, are partly attributed to insufficient attachment of the stent graft to the aortic wall. ONO1301, a chemically and biologically stable synthetic prostacyclin agonist, reportedly reorganizes the extracellular matrices, thus enhancing tissue healing. We hypothesized that ONO1301-coated stent grafts may strengthen the attachment between the graft and the aortic wall.
Methods: Polylactic and glycolic acid polymer-conjugated ONO1301, which releases ONO1301 into adjacent tissues over 3 months, was suspended in gelatin hydrogel. The stent graft, comprising a stainless steel stent and a woven polyester graft with (ONO(+)) or without (ONO(-)) the ONO1301 coating, was placed in the descending thoracic aorta of canines weighing 16-20 kg under general anesthesia and fluoroscopic guidance. The canines were examined at 1, 2, or 3 months after surgery (n = 4 at each time point and in each group).
Results: ONO1301 blood concentration increased sharply immediately after stent graft placement (7.21 ± 1.90 ng/dL), followed by a steady decrease until 2 months (0.57 ± 0.57 ng/dL) after surgery. The maximal load needed to tear off the stent graft from the aortic wall ex vivo was significantly greater in the ONO(+) than in the ONO(-) group at 2 and 3 months (Fig. 1). Immunohistochemically, αSMA-positive cells were abundantly present in the neointima in both groups. In Masson’s trichrome staining, fibrosis between the graft and the aortic wall progressed over time, whereas the fibrotic area was significantly greater in the ONO(+) than in the ONO(-) group at 3 months (Fig. 2).
Conclusion: The ONO1301-eluting stent graft enhanced the tissue reorganization between the stent graft and the aortic wall, which resulted in improved attachment between the 2 in canines. This new device may be useful in preventing the stent graft-related complications associated with its inappropriate attachment to the aortic wall.
- © 2013 by American Heart Association, Inc.