First experimental application of bevacizumab-eluting PC coated stent for inhibition of vasa vasorum of atherosclerotic plaque: angiographic results in a rabbit atheromatic model.
BACKGROUND
Atheromatosis is associated with angiogenesis, through the development of a dense net of vasa vasorum. The role of vascular endothelial growth factor (VEGF) is important in this process. Bevacizumab, an antibody specific for VEGF, has recently been applied in the clinical field. We hypothesized that local delivery of bevacizumab by stent would inhibit the development of vasa vasorum at the stented arterial segment in an atheromatic rabbit model.


METHODS
We used 10 New Zealand rabbits under atherogenic diet for 3 weeks. We immersed a BiodivYsio stent into a solution of 4 ml bevacizumab as in previous studies. Both eluting stents and non-eluting BiodivYsio stents were implanted in the middle segment of the 2 iliac arteries of the animals, with the same procedural characteristics. Sacrifice following repeat angiogram was scheduled after 28 days.


RESULTS
In all animals the procedure of stent loading with bevacizumab and stent implantation was successful. There was no acute or subacute thrombosis. Iliac artery lumen diameters before and immediately after stent placement were similar in all stent treatment groups. At euthanasia stent lumen diameters were similar in all groups. All stents were angiographically patent at the time of euthanasia without aneurysm formation. Moreover, gross pathologic analysis did not show any evidence of vascular necrosis.


CONCLUSIONS
Bevacizumab-eluting stent implantation in atheromatic rabbit iliac arteries is feasible and safe. This new approach for the treatment of stable and vulnerable plaques needs to be further investigated.
First Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece. cstefan@cc.uoa.gr
Christodoulos
C
Stefanadis
Konstantinos
K
Toutouzas
Elli
E
Stefanadi
Frank
F
Kolodgie
Renu
R
Virmani
Nicholas
N
Kipshidze
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D050197:Atherosclerosis / Q000188:drug therapy*; D000068258:Bevacizumab; D004195:Disease Models, Animal; D005240:Feasibility Studies; D007083:Iliac Artery; D011817:Rabbits; D015607:Stents; D014651:Vasa Vasorum / Q000187:drug effects*
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab