Impact of heterogeneous overlapping drug-eluting stents on the arterial responses of rabbit iliac arteries: A comparison with overlapping bare metal stents

Seung-Woon Rha, Kang Yin Chen, Dong Joo Oh, Yong Jian Li, Zhe Jin, Kanhaiya Lal Poddar, Sureshkumar Ramasamy, Yoshiyasu Minami, Amro Elnagar, Byoung Geol Choi, Sang Pyo Hong, Byoung Won Cheon, Sang Ki Moon, Sung Il Im, Sun Won Kim, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju KimSeong Woo Han, Chang Gyu Park, Hong Seog Seo, Jung Ha Kim, Young Joon Hong, Myung Ho Jeong

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and Objectives: Although the use of heterogeneous overlapping drug-eluting stents (DES) is not uncommon in clinical practice, whether the implantation sequences of heterogeneous DES will influence the endothelialization or arterial responses differently remains unclear. Materials and Methods: Twenty-one rabbits were randomized to receive overlapping stents in the iliac artery for 3 months {distal sirolimus-eluting stent (SES, Cypher™)+proximal paclitaxel-eluting stent (PES, Taxus™) (C+T, n=7), distal Taxus+proximal Cypher (T+C, n=7) and bare metal stent (BMS)+BMS (B+B, n=7)}. Endothelial function was evaluated by the acetylcholine provocation test during follow-up angiography. Histopathological changes in proximal, overlapped, and distal stented segments were evaluated. Results: Although the overall angiographic outcomes were comparable, late loss (mm) in the distal stented segment was higher in the B+B (0.39±0.07) and C+T (0.40±0.20) than that in the T+C (0.06±0.02) group (p<0.001). The incidence of acetylcholine-induced spasm was higher in the DES groups compared with BMS, regardless of the implantation sequences (85.7% in C+T vs. 14.3% in B+B vs. 71.4% in T+C, p=0.017). Notably, only the distal Cypher implantation group (C+T) had three cases of stent fracture. A histopathological analysis showed that despite similar arterial injury scores, Taxus and Cypher stents had higher inflammatory reactions at the overlapped and distal segments compared with those of BMS. Conclusion: Despite similar arterial injury, higher inflammatory reactions were observed in overlapping DES segments regardless of the implantation sequence compared with that of BMS. Moreover, DES was associated with impaired endothelial function on the adjacent non-stented segments.

Original languageEnglish
Pages (from-to)397-405
Number of pages9
JournalKorean Circulation Journal
Volume42
Issue number6
DOIs
Publication statusPublished - 2012 Jun 1

Fingerprint

Drug-Eluting Stents
Iliac Artery
Stents
Metals
Rabbits
Taxus
Acetylcholine
Wounds and Injuries
Spasm
Sirolimus
Paclitaxel
Angiography

Keywords

  • Drug-eluting stents
  • Endothelium
  • Vasoconstriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

Impact of heterogeneous overlapping drug-eluting stents on the arterial responses of rabbit iliac arteries : A comparison with overlapping bare metal stents. / Rha, Seung-Woon; Chen, Kang Yin; Oh, Dong Joo; Li, Yong Jian; Jin, Zhe; Poddar, Kanhaiya Lal; Ramasamy, Sureshkumar; Minami, Yoshiyasu; Elnagar, Amro; Choi, Byoung Geol; Hong, Sang Pyo; Cheon, Byoung Won; Moon, Sang Ki; Im, Sung Il; Kim, Sun Won; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Jin Won; Kim, Eung Ju; Han, Seong Woo; Park, Chang Gyu; Seo, Hong Seog; Kim, Jung Ha; Hong, Young Joon; Jeong, Myung Ho.

In: Korean Circulation Journal, Vol. 42, No. 6, 01.06.2012, p. 397-405.

Research output: Contribution to journalArticle

Rha, S-W, Chen, KY, Oh, DJ, Li, YJ, Jin, Z, Poddar, KL, Ramasamy, S, Minami, Y, Elnagar, A, Choi, BG, Hong, SP, Cheon, BW, Moon, SK, Im, SI, Kim, SW, Na, JO, Choi, CU, Lim, HE, Kim, JW, Kim, EJ, Han, SW, Park, CG, Seo, HS, Kim, JH, Hong, YJ & Jeong, MH 2012, 'Impact of heterogeneous overlapping drug-eluting stents on the arterial responses of rabbit iliac arteries: A comparison with overlapping bare metal stents', Korean Circulation Journal, vol. 42, no. 6, pp. 397-405. https://doi.org/10.4070/kcj.2012.42.6.397
Rha, Seung-Woon ; Chen, Kang Yin ; Oh, Dong Joo ; Li, Yong Jian ; Jin, Zhe ; Poddar, Kanhaiya Lal ; Ramasamy, Sureshkumar ; Minami, Yoshiyasu ; Elnagar, Amro ; Choi, Byoung Geol ; Hong, Sang Pyo ; Cheon, Byoung Won ; Moon, Sang Ki ; Im, Sung Il ; Kim, Sun Won ; Na, Jin Oh ; Choi, Cheol Ung ; Lim, Hong Euy ; Kim, Jin Won ; Kim, Eung Ju ; Han, Seong Woo ; Park, Chang Gyu ; Seo, Hong Seog ; Kim, Jung Ha ; Hong, Young Joon ; Jeong, Myung Ho. / Impact of heterogeneous overlapping drug-eluting stents on the arterial responses of rabbit iliac arteries : A comparison with overlapping bare metal stents. In: Korean Circulation Journal. 2012 ; Vol. 42, No. 6. pp. 397-405.
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abstract = "Background and Objectives: Although the use of heterogeneous overlapping drug-eluting stents (DES) is not uncommon in clinical practice, whether the implantation sequences of heterogeneous DES will influence the endothelialization or arterial responses differently remains unclear. Materials and Methods: Twenty-one rabbits were randomized to receive overlapping stents in the iliac artery for 3 months {distal sirolimus-eluting stent (SES, Cypher™)+proximal paclitaxel-eluting stent (PES, Taxus™) (C+T, n=7), distal Taxus+proximal Cypher (T+C, n=7) and bare metal stent (BMS)+BMS (B+B, n=7)}. Endothelial function was evaluated by the acetylcholine provocation test during follow-up angiography. Histopathological changes in proximal, overlapped, and distal stented segments were evaluated. Results: Although the overall angiographic outcomes were comparable, late loss (mm) in the distal stented segment was higher in the B+B (0.39±0.07) and C+T (0.40±0.20) than that in the T+C (0.06±0.02) group (p<0.001). The incidence of acetylcholine-induced spasm was higher in the DES groups compared with BMS, regardless of the implantation sequences (85.7{\%} in C+T vs. 14.3{\%} in B+B vs. 71.4{\%} in T+C, p=0.017). Notably, only the distal Cypher implantation group (C+T) had three cases of stent fracture. A histopathological analysis showed that despite similar arterial injury scores, Taxus and Cypher stents had higher inflammatory reactions at the overlapped and distal segments compared with those of BMS. Conclusion: Despite similar arterial injury, higher inflammatory reactions were observed in overlapping DES segments regardless of the implantation sequence compared with that of BMS. Moreover, DES was associated with impaired endothelial function on the adjacent non-stented segments.",
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T1 - Impact of heterogeneous overlapping drug-eluting stents on the arterial responses of rabbit iliac arteries

T2 - A comparison with overlapping bare metal stents

AU - Rha, Seung-Woon

AU - Chen, Kang Yin

AU - Oh, Dong Joo

AU - Li, Yong Jian

AU - Jin, Zhe

AU - Poddar, Kanhaiya Lal

AU - Ramasamy, Sureshkumar

AU - Minami, Yoshiyasu

AU - Elnagar, Amro

AU - Choi, Byoung Geol

AU - Hong, Sang Pyo

AU - Cheon, Byoung Won

AU - Moon, Sang Ki

AU - Im, Sung Il

AU - Kim, Sun Won

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Lim, Hong Euy

AU - Kim, Jin Won

AU - Kim, Eung Ju

AU - Han, Seong Woo

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Kim, Jung Ha

AU - Hong, Young Joon

AU - Jeong, Myung Ho

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Background and Objectives: Although the use of heterogeneous overlapping drug-eluting stents (DES) is not uncommon in clinical practice, whether the implantation sequences of heterogeneous DES will influence the endothelialization or arterial responses differently remains unclear. Materials and Methods: Twenty-one rabbits were randomized to receive overlapping stents in the iliac artery for 3 months {distal sirolimus-eluting stent (SES, Cypher™)+proximal paclitaxel-eluting stent (PES, Taxus™) (C+T, n=7), distal Taxus+proximal Cypher (T+C, n=7) and bare metal stent (BMS)+BMS (B+B, n=7)}. Endothelial function was evaluated by the acetylcholine provocation test during follow-up angiography. Histopathological changes in proximal, overlapped, and distal stented segments were evaluated. Results: Although the overall angiographic outcomes were comparable, late loss (mm) in the distal stented segment was higher in the B+B (0.39±0.07) and C+T (0.40±0.20) than that in the T+C (0.06±0.02) group (p<0.001). The incidence of acetylcholine-induced spasm was higher in the DES groups compared with BMS, regardless of the implantation sequences (85.7% in C+T vs. 14.3% in B+B vs. 71.4% in T+C, p=0.017). Notably, only the distal Cypher implantation group (C+T) had three cases of stent fracture. A histopathological analysis showed that despite similar arterial injury scores, Taxus and Cypher stents had higher inflammatory reactions at the overlapped and distal segments compared with those of BMS. Conclusion: Despite similar arterial injury, higher inflammatory reactions were observed in overlapping DES segments regardless of the implantation sequence compared with that of BMS. Moreover, DES was associated with impaired endothelial function on the adjacent non-stented segments.

AB - Background and Objectives: Although the use of heterogeneous overlapping drug-eluting stents (DES) is not uncommon in clinical practice, whether the implantation sequences of heterogeneous DES will influence the endothelialization or arterial responses differently remains unclear. Materials and Methods: Twenty-one rabbits were randomized to receive overlapping stents in the iliac artery for 3 months {distal sirolimus-eluting stent (SES, Cypher™)+proximal paclitaxel-eluting stent (PES, Taxus™) (C+T, n=7), distal Taxus+proximal Cypher (T+C, n=7) and bare metal stent (BMS)+BMS (B+B, n=7)}. Endothelial function was evaluated by the acetylcholine provocation test during follow-up angiography. Histopathological changes in proximal, overlapped, and distal stented segments were evaluated. Results: Although the overall angiographic outcomes were comparable, late loss (mm) in the distal stented segment was higher in the B+B (0.39±0.07) and C+T (0.40±0.20) than that in the T+C (0.06±0.02) group (p<0.001). The incidence of acetylcholine-induced spasm was higher in the DES groups compared with BMS, regardless of the implantation sequences (85.7% in C+T vs. 14.3% in B+B vs. 71.4% in T+C, p=0.017). Notably, only the distal Cypher implantation group (C+T) had three cases of stent fracture. A histopathological analysis showed that despite similar arterial injury scores, Taxus and Cypher stents had higher inflammatory reactions at the overlapped and distal segments compared with those of BMS. Conclusion: Despite similar arterial injury, higher inflammatory reactions were observed in overlapping DES segments regardless of the implantation sequence compared with that of BMS. Moreover, DES was associated with impaired endothelial function on the adjacent non-stented segments.

KW - Drug-eluting stents

KW - Endothelium

KW - Vasoconstriction

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