Titanium-nitride-oxide-coated coronary stents: insights from the available evidence.
Coating of stent surface with a biocompatible material is suggested to improve stent safety profile. A proprietary process was developed to coat titanium-nitride-oxide on the stent surface, based on plasma technology that uses the nano-synthesis of gas and metal. Preclinical in vitro and in vivo investigation confirmed blood compatibility of titanium (nitride-) oxide films. Titanium-nitride-oxide-coated stents demonstrated a better angiographic outcome, compared with bare-metal stents at mid-term follow-up; however, they failed to achieve non-inferiority for angiographic outcome versus second-generation drug-eluting stents. Observational studies showed adequate clinical outcome at mid-term follow-up. Non-randomized studies showed an outcome of titanium-nitride-oxide-coated stents comparable to - or better than - first-generation drug-eluting stents at long-term follow-up. Two randomized controlled trials demonstrated comparable efficacy outcome, and a better safety outcome of titanium-nitride-oxide-coated stents versus drug-eluting stents at long-term follow-up. Evaluation by optical coherence tomography at mid-term follow-up revealed better neointimal strut coverage associated with titanium-nitride-oxide-coated stents versus drug-eluting stents; yet, neointimal hyperplasia thickness was greater. Key messages Stents coated with titanium-nitride-oxide demonstrated biocompatibility in preclinical studies: they inhibit platelet and fibrin deposition, and reduce neointimal growth. In observational and non-randomized studies, titanium-nitride-oxide-coated stents were associated with adequate safety and efficacy outcome. In randomized trials of patients with acute coronary syndrome, titanium-nitride-oxide-coated stents were associated with a better safety outcome, compared with drug-eluting stents; efficacy outcome was comparable.
a Heart Center, Satakunta Central Hospital , Pori , Finland.
Pasi P
PP
Karjalainen
a Heart Center, Satakunta Central Hospital , Pori , Finland.
Wail
W
Nammas
D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D058426:Neointima / Q000188:drug therapy*; D064887:Observational Studies as Topic; D015607:Stents; D014025:Titanium / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; C434243:titanium-nitride-oxide; D014025:Titanium
Outcome; percutaneous coronary intervention; titanium-nitride-oxide-coated stents