Coronary interventions - Mini focus on drug-eluting stents

Comparison of acute thrombogenicity and albumin adsorption in three different durable polymer coronary drug-eluting stents

EuroIntervention 2021;17:248-256. DOI: 10.4244/EIJ-D-19-00938

Hiroyuki Jinnouchi
Hiroyuki Jinnouchi1, MD; Matthew Kutyna1, MS; Sho Torii1, MD; Qi Cheng1, MD; Atsushi Sakamoto1, MD; Liang Guo1, PhD; Anne Cornelissen1, MD; Laura E.L. Perkins2, DVM, PhD; Syed F. Hossainy2, PhD; Stephen D. Pacetti2, MS; Frank D. Kolodgie1, PhD; Renu Virmani1, MD; Aloke V. Finn1, MD
1. CVPath Institute, Gaithersburg, MD, USA; 2. Abbott Vascular, Santa Clara, CA, USA

Background: The relative thrombogenicity and albumin adsorption and retention of different durable polymers used in coronary stents has not been tested.

Aims: This study sought to compare the thromboresistance and albumin binding capacity of different durable polymer drug-eluting stents (DES) using dedicated preclinical and in vitro models.

Methods: In an ex vivo swine arteriovenous shunt model, a fluoropolymer everolimus-eluting stent (FP-EES) (n=14) was compared with two durable polymer DES, the BioLinx polymer-coated zotarolimus-eluting stent (BL-ZES) (n=9) and a CarboSil elastomer polymer-coated ridaforolimus-eluting stent (EP-RES) (n=6), and bare metal stents (BMS) (n=10). Stents underwent immunostaining using a cocktail of antiplatelet antibodies and a marker for inflammation and were then evaluated by confocal microscopy (CM). Albumin retention was assessed using a flow loop model with labelled human serum albumin (FP-EES [n=8], BL-ZES [n=4], EP-RES [n=4], and BMS [n=7]), and scanned by CM.

Results: The area of platelet adherence (normalised to total stent surface area) was lower in the order FP-EES (9.8%), BL-ZES (32.7%), EP-RES (87.6%) and BMS (202.0%), and inflammatory cell density was least for FP-EES <BL-ZES <EP-RES <BMS. Although nearly full coverage by albumin binding was shown for all durable polymer DES, FP-EES showed significantly greater intensity of albumin as compared to BL-ZES, EP-RES and BMS (FP-EES 79.0%; BL-ZES 13.2%; EP-RES 6.1%; BMS 1.5%).

Conclusions: These results suggest that thromboresistance and albumin retention vary by polymer type and that these differences might result in different suitability for short-term dual antiplatelet therapy.

Sign in to read and download the full article

Forgot your password?

No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from

stent thrombosisstable anginaacs/nste-acs
Coronary interventionsOther coronary interventions
Read next article
Transapical transcatheter mitral valve implantation in patients with prior aortic valve replacement: a feasibility report

Latest news