title: Thrombogenicity and early vascular healing response in metallic biodegradable polymer-based and fully bioabsorbable drug-eluting stents.
abstract: BACKGROUND
  Acute thrombogenicity and re-endothelialization represent clinically relevant end points pertaining to the safety of coronary stents, which have not been compared among biodegradable polymer-based drug-eluting metallic stents and fully bioabsorbable scaffolds to date.
  
  
  RESULTS
  We investigated comparative outcomes with respect to acute thrombogenicity and re-endothelialization among thin-strut biodegradable polymer metallic everolimus eluting stents (EES), thick-strut fully bioabsorbable EES, thick-strut biodegradable polymer metallic biolimus-eluting stents and control bare metal stents. An ex-vivo porcine arterio-venous shunt model was used to assess platelet aggregation, whereas a healthy rabbit model of iliofemoral stent implantation was used to assess re-endothelialization and inflammation. Confocal microscopy was used to detect fluorescently labeled antibody staining directed against CD61/CD42b for the identification of aggregated thrombocytes, CD14/PM-1, and RAM-11 for identification of neutrophils and monocytes/macrophages. Endothelial recovery was assessed by scanning electron microscopy, whereas CD31/PECAM-1 was used to confirm endothelial maturity. EES demonstrated significantly less acute thrombogenicity compared with bioabsorbable EES and biolimus-eluting stents. EES showed greater re-endothelialization at 28 days and reduced inflammatory cell adhesion of monocytes/macrophages at 14 days compared with bioabsorbable EES. Only bare metal stents showed complete re-endothelialization at 28 days.
  
  
  CONCLUSIONS
  These outcomes indicate differential trends in thrombogenicity and vascular healing among contemporary stents used in clinical practice and suggest a need for long-term adjunct antithrombotic pharmacotherapy for bioabsorbable EES.
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA.
authors.forename: Tobias
authors.initials: T
authors.lastname: Koppara
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Cheng
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Yahagi
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Mori
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA.
authors.forename: Oscar David
authors.initials: OD
authors.lastname: Sanchez
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA.
authors.forename: Julia
authors.initials: J
authors.lastname: Feygin
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA.
authors.forename: Eric
authors.initials: E
authors.lastname: Wittchow
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA.
authors.forename: Frank D
authors.initials: FD
authors.lastname: Kolodgie
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA.
authors.forename: Renu
authors.initials: R
authors.lastname: Virmani
authors.affiliation: From the CVPath Institute Inc (T.K., Q.C., K.Y., H.M., O.D.S., E.W., F.D.K., R.V., M.J.), Gaithersburg, MD; and Boston Scientific Corporation (J.F.), Marlborough, MA. mjoner@cvpath.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Joner
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects / Q000706:statistics & numerical data*; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001166:Arteriovenous Shunt, Surgical; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000706:statistics & numerical data*; D004730:Endothelium, Vascular / Q000502:physiology*; D000068338:Everolimus / Q000008:administration & dosage; D007083:Iliac Artery / Q000601:surgery; D007249:Inflammation / Q000209:etiology; D023421:Models, Animal; D011817:Rabbits; D011897:Random Allocation; D013552:Swine; D013927:Thrombosis / Q000209:etiology*
chemical_list: D000970:Antineoplastic Agents; D000068338:Everolimus
keywords: coronary artery disease; drug delivery; drug-eluting stents; polymer