The preventive effects of the heparin-coated coronary stent in a porcine coronary stent restenosis model

Kim, Joon Woo; Jeong, Myung Ho; Kim, Seong Hee; Cho, Jang Hyun; Ahn, Young Keun; Park, Joo Hyung; Cho, Jeong Gwan; Park, Chang Soo; Juhng, Sang Woo; Park, Jong Chun; Kang, Jung Chaee

Abstract

BACKGROUND: The coronary stent reduces acute coronary arterial occlusion and late restenosis during and after coronary intervention. However, stent thrombosis and restenosis are still major limitations in widespread use of coronary stent. Local drug delivery with use of heparin-coated stent will be a new approach reducing the incidence of stent thrombosis and restenosis. In order to evaluate the effects of heparin-coated stent on stent restenosis, heparin-coated stents were compared with control stents in a porcine coronary stent restenosis model.
METHODS
Stent overdilation injury (stent:artery= 1.3:1.0) was performed with bare Wiktor (Group I, n=10) and heparin-coated Wiktor (Group II, n=20) stents (HEPAMEDTM, Medtronics, U.S.A.) in porcine coronary arteries. Follow-up quantitative coronary angiography (QCA) was performed at 4 weeks after stenting and histopathologic assessments of stented porcine coronary arteries were compared in both groups.
RESULTS
1) On QCA, percent diameter stenosis was significantly higher in Group I than in Group II (16.3+/-6.62% vs. 9.6+/-5.06%, p<0.05). 2) Injury score of stented porcine coronary artery was not different in both groups (1.26+/-0.23 vs. 1.20+/-0.22). 3) Pathologic area stenosis of stented artery was higher in Group I than in Group II (41.6+/-12.5% vs. 27.1+/-9.9%, p<0.005). 4) Neointimal area was higher in Group I than in Group II (4.58+/-1.41 mm2 vs. 2.57+/-1.07 mm2, p<0.05). 5) By immunohistochemistry, proliferating cell nuclear antigen (PCNA) index was higher in Group I compared with in Group II (11.2+/-6.75% vs. 6.3+/-4.14%, p<0.05).
CONCLUSIONS
Heparin-coated stent is effective in the prevention of late coronary stent restenosis in a porcine coronary stent restenosis model, which may be related with the inhibition of neointimal cell proliferation.