title: Sustained Efficacy and Arterial Drug Retention by a Fast Drug Eluting Cross-Linked Fatty Acid Coronary Stent Coating.
abstract: The long held assumption that sustained drug elution from stent coatings over weeks to months is imperative for clinical efficacy has limited the choice for stent coating materials. We developed and evaluated an omega-3 fatty acid (O3FA) based stent coating that is 85% absorbed and elutes 97% of its Sirolimus analog (Corolimus) load within 8d of implantation. O3FA coated stents sustained drug levels in porcine coronary arteries similarly to those achieved by slow-eluting durable coated Cypher Select Plus Stents and with significantly lower levels of granuloma formation and luminal stenosis. Computational modeling confirmed that diffusion and binding constants of Corolimus and Sirolimus are identical and explained that the sustained retention of Corolimus was facilitated by binding to high affinity intracellular receptors (FKBP12). First in man outcomes were positive-unlike Cypher stents where late lumen loss drops over 6 month, there was a stable effect without diminution in the presence of O3FA. These results speak to a new paradigm whereby the safety of drug eluting stents can be optimized through the use of resorbable biocompatible coating materials with resorption kinetics that coincide with the dissociation and tissue elimination of receptor-bound drug.
authors: Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.|Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors: Natalie
authors: N
authors: Artzi
authors: Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA. ramitz@mit.edu.|Department of Applied Science, CBSET Inc., Lexington, MA, USA. ramitz@mit.edu.
authors: Abraham R
authors: AR
authors: Tzafriri
authors: MAQUET Vascular Systems (Formerly Atrium Medical Corporation), 40 Continental Blvd., Merrimack, NH, 03054, USA.
authors: Keith M
authors: KM
authors: Faucher
authors: MAQUET Vascular Systems (Formerly Atrium Medical Corporation), 40 Continental Blvd., Merrimack, NH, 03054, USA.
authors: Geoffrey
authors: G
authors: Moodie
authors: MAQUET Vascular Systems (Formerly Atrium Medical Corporation), 40 Continental Blvd., Merrimack, NH, 03054, USA.
authors: Theresa
authors: T
authors: Albergo
authors: MAQUET Vascular Systems (Formerly Atrium Medical Corporation), 40 Continental Blvd., Merrimack, NH, 03054, USA.
authors: Suzanne
authors: S
authors: Conroy
authors: MAQUET Vascular Systems (Formerly Atrium Medical Corporation), 40 Continental Blvd., Merrimack, NH, 03054, USA.
authors: Scott
authors: S
authors: Corbeil
authors: MAQUET Vascular Systems (Formerly Atrium Medical Corporation), 40 Continental Blvd., Merrimack, NH, 03054, USA.
authors: Paul
authors: P
authors: Martakos
authors: CV Path Institute, 19 Firstfield Road, Gaithersburg, MD, 20878, USA.
authors: Renu
authors: R
authors: Virmani
authors: Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.|Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors: Elazer R
authors: ER
authors: Edelman
mesh_terms: D000818:Animals; D020099:Coated Materials, Biocompatible / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology; D015525:Fatty Acids, Omega-3 / Q000737:chemistry; D008297:Male; D008422:Materials Testing; D008955:Models, Cardiovascular; D011817:Rabbits; D020123:Sirolimus / Q000737:chemistry / Q000493:pharmacokinetics; D013552:Swine
chemical_list: D020099:Coated Materials, Biocompatible; D015525:Fatty Acids, Omega-3; D020123:Sirolimus
keywords: Computational modeling; Drug eluting stents; Sirolimus analogs