title: Ultra-hydrophilic stent platforms promote early vascular healing and minimise late tissue response: a potential alternative to second-generation drug-eluting stents.
abstract: OBJECTIVE
  Simple surface modifications can enhance coronary stent performance. Ultra-hydrophilic surface (UHS) treatment of contemporary bare metal stents (BMS) was assessed in vivo to verify whether such stents can provide long-term efficacy comparable to second-generation drug-eluting stents (DES) while promoting healing comparably to BMS.
  
  
  RESULTS
  UHS-treated BMS, untreated BMS and corresponding DES were tested for three commercial platforms. A thirty-day and a 90-day porcine coronary model were used to characterise late tissue response. Three-day porcine coronary and seven-day rabbit iliac models were used for early healing assessment. In porcine coronary arteries, hydrophilic treatment reduced intimal hyperplasia relative to the BMS and corresponding DES platforms (1.5-fold to threefold reduction in 30-day angiographic and histological stenosis; p<0.04). Endothelialisation was similar on UHS-treated BMS and untreated BMS, both in swine and rabbit models, and lower on DES. Elevation in thrombotic indices was infrequent (never observed with UHS, rare with BMS, most often with DES), but, when present, correlated with reduced endothelialisation (p<0.01).
  
  
  CONCLUSIONS
  Ultra-hydrophilic surface treatment of contemporary stents conferred good healing while moderating neointimal and thrombotic responses. Such surfaces may offer safe alternatives to DES, particularly when rapid healing and short dual antiplatelet therapy (DAPT) are crucial.
authors.affiliation: Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors.forename: Kumaran
authors.initials: K
authors.lastname: Kolandaivelu
authors.forename: Lynn
authors.initials: L
authors.lastname: Bailey
authors.forename: Stefano
authors.initials: S
authors.lastname: Buzzi
authors.forename: Arik
authors.initials: A
authors.lastname: Zucker
authors.forename: Vincent
authors.initials: V
authors.lastname: Milleret
authors.forename: Algirdas
authors.initials: A
authors.lastname: Ziogas
authors.forename: Martin
authors.initials: M
authors.lastname: Ehrbar
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Khattab
authors.forename: James R L
authors.initials: JRL
authors.lastname: Stanley
authors.forename: Gee K
authors.initials: GK
authors.lastname: Wong
authors.forename: Brett
authors.initials: B
authors.lastname: Zani
authors.forename: Peter M
authors.initials: PM
authors.lastname: Markham
authors.forename: Abraham R
authors.initials: AR
authors.lastname: Tzafriri
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: Elazer R
authors.initials: ER
authors.lastname: Edelman
mesh_terms: D000818:Animals; D057927:Hydrophobic and Hydrophilic Interactions; D058426:Neointima / Q000517:prevention & control; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation*; D011817:Rabbits; D015607:Stents; D013552:Swine; D013927:Thrombosis / Q000517:prevention & control