Chonnam Med J.  2009 Aug;45(2):87-91. 10.4068/cmj.2009.45.2.87.

Inhibitory Effect of Double Coating with Echinomycin and Hydrophobic Heparin in a Porcine Coronary In-Stent Restenosis Model

• Lim SY
• Jeong MH
• Sim DS
• Hong YJ
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC
• Moon HT
• Byun Y

• KMID: 2172266
• DOI: http://doi.org/10.4068/cmj.2009.45.2.87

Abstract

Stent thrombosis and in-stent restenosis are still major limitations of coronary stenting. Here, we report on a new type of drug-eluting stent (DES) aimed to prevent restenosis and thrombosis. The DES was prepared by coating a bare metal stent with echinomycin (an anti-proliferative drug) and hydrophobic heparin. The echinomycin-hydrophobic heparin double-coating stents were compared with control stents in a porcine coronary stent restenosis model. Stent overdilation injury (stent : artery=1.1 : 1.0) was compared in porcine coronary arteries between 4 groups: bare stent group (Group I, n=3), 1% echinomycin-heparin coating stent group (Group II, n=3), 5% echinomycin-heparin coating stent group (Group III, n=3), and 10% echinomycin-heparin coating stent group (Group IV, n=3). Follow-up quantitative coronary angiography was performed 4 weeks after the stents were inserted. The histopathologic assessments of the stented porcine coronary arteries were compared between the 4 groups. The neointimal areas of the stented arteries were 4.3+/-1.3 mm2 in Group I, 5.7+/-1.3 mm2 in Group II, 3.7+/-1.0 mm2 in Group III, and 2.7+/-1.1 mm2 in Group IV; the neointimal area was significantly larger in Group II than in the other groups (p<0.001). The histopathologic areas of stenosis were 61.4+/-18.1% in Group I, 79.8+/-24.0% in Group II, 52.0+/-18.5% in Group III, and 30.9+/-14.6% in Group IV; the histopathologic area was significantly smaller in Group IV than in the other groups (p<0.001). In conclusion, echinomycin-hydrophobic heparin double-coating stents effectively inhibit neointimal proliferation at a relatively high level.

Keyword

Stents; Restenosis; Thrombosis; Prevention

MeSH Terms

Arteries
Constriction, Pathologic
Coronary Angiography
Coronary Vessels
Drug-Eluting Stents
Echinomycin
Follow-Up Studies
Heparin
Stents
Thrombosis
Echinomycin
Heparin

Figure

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  Fig. 1 Histopathology of pigs coronary arteries 4 weeks after stents implantation, Hematoxyline and eosin stain. (A) Group I: control (bare stent) group, (B) Group II: 1% echinomycin, (C) Group III: 5% echinomycin, (D) Group IV: 10% echinomycin, respectively.

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