Axel Rentzsch, Eva Metz, Ruben Mühl-Benninghaus, Alexander Maßmann, Stephanie Bettink, Bruno Scheller, Lilia Lemke, Ali Awadelkareem, Toshiki Tomori, Ayman Haidar, Matthias W Laschke, Michael D Menger, Cenk Aktas, Matthias Hannig, Norbert Pütz, Thomas Büttner, David Scheschkewitz, Michael Veith, Hashim Abdul-Khaliq
{"title":"In vivo biocompatibility of a new hydrophobic coated Al/Al<sub>2</sub>O<sub>3</sub> nanowire surface on stents.","authors":"Axel Rentzsch, Eva Metz, Ruben Mühl-Benninghaus, Alexander Maßmann, Stephanie Bettink, Bruno Scheller, Lilia Lemke, Ali Awadelkareem, Toshiki Tomori, Ayman Haidar, Matthias W Laschke, Michael D Menger, Cenk Aktas, Matthias Hannig, Norbert Pütz, Thomas Büttner, David Scheschkewitz, Michael Veith, Hashim Abdul-Khaliq","doi":"10.1016/j.carrev.2024.08.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Intima proliferation and in-stent restenosis is a challenging situation in interventional treatment of small vessel obstruction. Al/Al<sub>2</sub>O<sub>3</sub> nanowires have been shown to accelerate vascular endothelial cell proliferation and migration in vitro, while suppressing vascular smooth muscle cell growth. Moreover, surface modification of Al/Al<sub>2</sub>O<sub>3</sub> nanowires with poly[bis(2,2,2-trifluoromethoxy)phosphazene (PTFEP) coating enables further advantages such as reduced platelet adhesion. Therefore, the study's goal was to compare the biocompatibility of novel Al/Al<sub>2</sub>O<sub>3</sub> + PTFEP coated nanowire bare-metal stents to uncoated control stents in vivo using optical coherence tomography (OCT), quantitative angiography and histomorphometric assessment.</p><p><strong>Methods: </strong>15 Al/Al<sub>2</sub>O<sub>3</sub> + PTFEP coated and 19 control stents were implanted in the cervical arteries of 9 Aachen minipigs. After 90 days, in-stent stenosis, thrombogenicity, and inflammatory response were assessed. Scanning electron microscopy was used to analyse the stent surface.</p><p><strong>Results: </strong>OCT analysis revealed that neointimal proliferation in Al/Al<sub>2</sub>O<sub>3</sub> + PTFEP coated stents was significantly reduced compared to control stents. The neointimal area was 1.16 ± 0.77 mm<sup>2</sup> in Al/Al<sub>2</sub>O<sub>3</sub> + PTFEP coated stents vs. 1.98 ± 1.04 mm<sup>2</sup> in control stents (p = 0.004), and the neointimal thickness was 0.28 ± 0.20 vs. 0.47 ± 0.10 (p = 0.003). Quantitative angiography showed a tendency to less neointimal growth in coated stents. Histomorphometry showed no significant difference between the two groups and revealed an apparent inflammatory reaction surrounding the stent struts.</p><p><strong>Conclusions: </strong>At long-term follow-up, Al/Al<sub>2</sub>O<sub>3</sub> + PTFEP coated stents placed in peripheral arteries demonstrated good tolerance with no treatment-associated vascular obstruction and reduced in-stent restenosis in OCT. These preliminary in vivo findings indicate that Al/Al<sub>2</sub>O<sub>3</sub> + PTFEP coated nanowire stents may have translational potential to be used for the prevention of in-stent restenosis.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Revascularization Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.carrev.2024.08.017","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Intima proliferation and in-stent restenosis is a challenging situation in interventional treatment of small vessel obstruction. Al/Al2O3 nanowires have been shown to accelerate vascular endothelial cell proliferation and migration in vitro, while suppressing vascular smooth muscle cell growth. Moreover, surface modification of Al/Al2O3 nanowires with poly[bis(2,2,2-trifluoromethoxy)phosphazene (PTFEP) coating enables further advantages such as reduced platelet adhesion. Therefore, the study's goal was to compare the biocompatibility of novel Al/Al2O3 + PTFEP coated nanowire bare-metal stents to uncoated control stents in vivo using optical coherence tomography (OCT), quantitative angiography and histomorphometric assessment.
Methods: 15 Al/Al2O3 + PTFEP coated and 19 control stents were implanted in the cervical arteries of 9 Aachen minipigs. After 90 days, in-stent stenosis, thrombogenicity, and inflammatory response were assessed. Scanning electron microscopy was used to analyse the stent surface.
Results: OCT analysis revealed that neointimal proliferation in Al/Al2O3 + PTFEP coated stents was significantly reduced compared to control stents. The neointimal area was 1.16 ± 0.77 mm2 in Al/Al2O3 + PTFEP coated stents vs. 1.98 ± 1.04 mm2 in control stents (p = 0.004), and the neointimal thickness was 0.28 ± 0.20 vs. 0.47 ± 0.10 (p = 0.003). Quantitative angiography showed a tendency to less neointimal growth in coated stents. Histomorphometry showed no significant difference between the two groups and revealed an apparent inflammatory reaction surrounding the stent struts.
Conclusions: At long-term follow-up, Al/Al2O3 + PTFEP coated stents placed in peripheral arteries demonstrated good tolerance with no treatment-associated vascular obstruction and reduced in-stent restenosis in OCT. These preliminary in vivo findings indicate that Al/Al2O3 + PTFEP coated nanowire stents may have translational potential to be used for the prevention of in-stent restenosis.
期刊介绍:
Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.