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KMID : 1011220170030020017
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Clinical & Experimental Thrombosis and Hemostasis
2017 Volume.3 No. 2 p.17 ~ p.23
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Effect of a Non-polymer Titanium Dioxide Thin Film-Coated Stent with Heparin in a Porcine Coronary Restenosis Model
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Lim Kyung-Seob
Jeong Myung-Ho
Bae In-Ho
Park Jun-Kyu
Park Dae-Sung
Shim Jae-Won
Kim Han-Byual
Jin Mi-Rim
Kim Hyun-Kuk
Kim Sung-Soo
Kim Min-Chul
Sim Doo-Sun
Hong Young-Joon
Kim Ju-Han
Ahn Young-Keun
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Abstract
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Purpose: The aim of this study was to examine the effect of non-polymer titanium dioxide (TiO2) thin film-coated stents modified with heparin in a porcine coronary overstretch restenosis model.
Methods: Pigs were randomized into three groups in which either TiO2 film-heparin coated stent (THS, n=12), zotarolimus-eluting stent with polymer (ZES, n=12), or bare metal stent (BMS, n=12) was placed in a coronary artery (18 pigs, 12 coronaries in each group). Histopathologic analysis was performed at 28 days after stenting.
Results: There was no significant difference in injury score among the three groups. There were significant differences in neointima area (2.9±0.85 mm2 in the THS group vs. 2.8±0.10 mm2 in the ZES group vs. 3.3±0.58 mm2 in the BMS group, P<0.05), fibrin score (0.0 [range 0.0 to 1.0] in the THS group vs. 2.0 [range 2.0 to 2.0] in the ZES group vs. 0.5 [range 0.0 to 2.0] in the BMS group, P<0.0001), and inflammation score (1.0 [range 0.0-1.0] in the THS group vs. 1.0 [range 1.0 to 2.0] in the ZES group vs. 1.0 [range 0.75 to 1.0] in the BMS group, P<0.0001) among the three groups. In-stent restenosis rate, as measured by micro computed tomography, demonstrated similar percent area values upon histology analysis (57.7±13.14% in the THS group vs. 58.7±16.44% in the ZES group 64.8±8.56% in the BMS group, P<0.05).
Conclusion: THS is more effective in reducing neointima formation compared to BMS. Moreover, the neointima suppressive effect of THS exceeds that of commercial ZES, with lower fibrin and inflammation scores in a porcine coronary restenosis model.
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KEYWORD
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Stents, Percutaneous coronary intervention, Restenosis, Inflammation
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