Paclitaxel stent coating inhibits neointimal hyperplasia at 4 weeks in a porcine model of coronary restenosis

Despite limiting elastic recoil and late vascular remodeling after angioplasty, coronary stents remain vulnerable to restenosis, caused primarily by neointimal hyperplasia. Paclitaxel, a microtubule-stabilizing drug, has been shown to inhibit vascular smooth muscle cell migration and proliferation c...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2001-05, Vol.103 (18), p.2289-2295
Main Authors: HELDMAN, Alan W, CHENG, Linda, BUNGE, Katherine E, KINSELLA, James L, SOLLOTT, Steven J, LAKATTA, Edward G, BRINKER, Jeffrey A, HUNTER, William L, FROEHLICH, Jeffrey P, JENKINS, G. Mark, HELLER, Phillip F, KIM, Dong-Woon, WARE, Melvin JR, NATER, Cynthia, HRUBAN, Ralph H, REZAI, Banafsheh, ABELLA, Benjamin S
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Coronary Angiography
Coronary Vessels - chemistry
Coronary Vessels - drug effects
Coronary Vessels - surgery
Disease Models, Animal
Diseases of the cardiovascular system
Dose-Response Relationship, Drug
Female
Graft Occlusion, Vascular - pathology
Graft Occlusion, Vascular - prevention & control
Hyperplasia - pathology
Hyperplasia - prevention & control
Infusion Pumps, Implantable
Male
Medical sciences
Paclitaxel - administration & dosage
Paclitaxel - analysis
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Stents
Surface Properties
Swine, Miniature
Tunica Intima - drug effects
Tunica Intima - pathology
Tunica Intima - surgery
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Summary:Despite limiting elastic recoil and late vascular remodeling after angioplasty, coronary stents remain vulnerable to restenosis, caused primarily by neointimal hyperplasia. Paclitaxel, a microtubule-stabilizing drug, has been shown to inhibit vascular smooth muscle cell migration and proliferation contributing to neointimal hyperplasia. We tested whether paclitaxel-coated coronary stents are effective at preventing neointimal proliferation in a porcine model of restenosis. Palmaz-Schatz stents were dip-coated with paclitaxel (0, 0.2, 15, or 187 microgram/stent) by immersion in ethanolic paclitaxel and evaporation of the solvent. Stents were deployed with mild oversizing in the left anterior descending coronary artery (LAD) of 41 minipigs. The treatment effect was assessed 4 weeks after stent implantation. The angiographic late loss index (mean luminal diameter) decreased with increasing paclitaxel dose (P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.103.18.2289