In vitro thrombogenicity of drug-eluting and bare metal stents. Issue 185 (January 2020)

• Record Type: Journal Article
• Authors: Palmerini, Tullio; Barozzi, Chiara; Tomasi, Luciana; Riva, Diego Della; Marengo, Mario; Cicoria, Gianfranco; Bruno, Antonio G.; Bacchi-Reggiani, Maria-Letizia; Naldi, Marina; Bartolini, Manuela; Fanti, Stefano; Galiè, Nazzareno; Stone, Gregg W.
• Is Part Of: Thrombosis research. Issue 185(2020)
• Page Start: 43
• Page End: 48
• Publication Date: 2020-01
• Subjects: Stent thrombosis -- Bare metal stent -- Drug-eluting stent; BMS bare metal stent -- DES drug-eluting stent -- HSA human serum albumin -- PBS phosphate buffered saline -- PCI percutaneous coronary intervention -- FP-BMS fluoropolymer coated bare metal stent; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2019.11.016
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Aims: We sought to investigate the thrombogenicity of different DES and BMS in an in vitro system of stent perfusion. Material and methods: The experimental model consisted of a peristaltic pump connected to 4 parallel silicone tubes in which different stents were deployed. Blood was drawn from healthy volunteers and the amount of stent surfaced-induced thrombus deposition was determined using 125 I-fibrinogen. Results: Compared to Resolute, Biomatrix and Vision, Xience was associated with the lowest amount of stent surface-induced thrombus formation, with a significant difference compared to Vision ( 125 I-fibrinogen median value deposition [IQ range]: 50 ng [25–98] versus 560 ng [320–1520], respectively, p < 0.05), but not to other DES. In the second set of experiments Fluoropolymer-coated BMS not eluting drug was associated with a significant 3-fold reduction in 125 I-fibrinogen deposition (245 ng [80–300]) compared to Vision (625 ng [320–760], p < 0.05), but a 7-fold increase compared to Xience (35 ng [20–60], p < 0.05). Finally Xience was associated with a significantly greater absorption of albumin compared to BMS. Conclusions: In an in vitro system of stent perfusion, Xience was associated with the lowest amount of stent surface-induced thrombus formation compared with Resolute, Biomatrix and Vision, with a noted synergistic effect between the fluoropolymer and the drug. Highlights: The thrombogenicity of different stents was studied in an in vitro model. Fluoropolymer coated drug-eluting stents are less thrombogenic than bare metal stents. Fluoropolymers have thromboresistant properties. Fluoropolymer-coated stents absorb albumin more avidly than bare metal stents. Fluoropolymers and everolimus have a synergistic antithrombotic action.