Stent-based delivery of sirolimus reduces neointimal formation in a porcine coronary model

Takeshi Suzuki, Greg Kopia, Shin Ichiro Hayashi, Lynn R. Bailey, Gerard Llanos, Robert Wilensky, Bruce D. Klugherz, George Papandreou, Pallassana Narayan, Martin B. Leon, Alan C. Yeung, Fermin Tio, Philip S. Tsao, Robert Falotico, Andrew J. Carter

Research output: Contribution to journalArticlepeer-review

587 Scopus citations

Abstract

Background - The purpose of this study was to determine the efficacy of stent-based delivery of sirolimus (SRL) alone or in combination with dexamethasone (DEX) to reduce in-stent neointimal hyperplasia. SRL is a potent immunosuppressive agent that inhibits SMC proliferation by blocking cell cycle progression. Methods and Results - Stents were coated with a nonerodable polymer containing 185 μg SRL, 350 μg DEX, or 185 μg SRL and 350 μg DEX. Polymer biocompatibility studies in the porcine and canine models showed acceptable tissue response at 60 days. Forty-seven stents (metal, n=13; SRL, n=13; DEX, n=13; SRL and DEX, n=8) were implanted in the coronary arteries of 16 pigs. The tissue level of SRL was 97±13 ng/artery, with a stent content of 71±10 μg at 3 days. At 7 days, proliferating cell nuclear antigen and retinoblastoma protein expression were reduced 60% and 50%, respectively, by the SRL stents. After 28 days, the mean neointimal area was 2.47±1.04 mm2 for the SRL alone and 2.42±1.04 mm2 for the combination of SRL and DEX compared with the metal (5.06±1.88 mm2, P<0.0001) or DEX-coated stents (4.31±3.21 mm2, P<0.001), resulting in a 50% reduction of percent in-stent stenosis. Conclusions - Stent-based delivery of SRL via a nonerodable polymer matrix is feasible and effectively reduces in-stent neointimal hyperplasia by inhibiting cellular proliferation.

Original languageEnglish (US)
Pages (from-to)1188-1193
Number of pages6
JournalCirculation
Volume104
Issue number10
DOIs
StatePublished - Sep 4 2001
Externally publishedYes

Keywords

  • Restenosis
  • Sirolimus
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint

Dive into the research topics of 'Stent-based delivery of sirolimus reduces neointimal formation in a porcine coronary model'. Together they form a unique fingerprint.

Cite this