Abnormal Vasomotor Function of Porcine Coronary Arteries Distal to Sirolimus-Eluting Stents
Jinsheng Li, MD, PhD,
Refat Jabara, MD*,
Lakshmana Pendyala, MD,
Yoritaka Otsuka, MD,
Toshiro Shinke, MD,
Dongming Hou, MD, PhD, FACC,
Keith Robinson, PhD, FACC,
Nicolas Chronos, MD, FACC
Saint Joseph's Translational Research Institute/Saint Joseph's Hospital of Atlanta, Georgia.
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Figure 1 Angiography and Macroscopy of Coronary Segments
(A) Coronary angiography 1 month after stent implant in LAD (top arrow); segments studied were the distal conduit vessel (bottom arrow). (B) Macroscopy at tissue harvest showing the LAD stent (top arrow) and relation to distal conduit vessel segment (bottom arrows) harvested and analyzed in the organ chamber apparatus. LAD = left anterior descending artery.
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Figure 2 Histologic Sections of Stented Arteries
Illustrative histological sections from BMS, POLY, and SES groups. BMS = bare-metal stent(s); POLY = polymer-only coated stent(s); SES = sirolimus-eluting stent(s).
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Figure 3 Contractile Responses of Coronary Segments Distal to Stents
Contractile responses to constriction agonists for coronary arteries distal to BMS, POLY, and SES stents. (A) In the presence of NW-nitro-L-arginine methyl ester (L-NAME), contractile response to prostaglandin F2 (PGF2) was increased for SES (*p = 0.008). (B) The contractile response to endothelin (ET)-1 was also increased for SES (*p = 0.021). Abbreviations as in Figure 2.
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Figure 4 Relaxation Responses of Coronary Segments Distal to Stents
Cumulative concentration–relaxation curves for coronary artery segments distal to BMS, POLY, and SES. (A) Relaxation to higher concentrations of endothelium–dependent vasodilator substance P was inhibited in coronary segments distal to SES compared with BMS and POLY (*p < 0.05). (B) Relaxation to the highest concentration of the endothelium-independent dilator sodium nitroprusside was higher for SES compared with BMS and POLY (*p < 0.02). Abbreviations as in Figures 1 and 2.
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Figure 5 Effect of Nitric Oxide Synthase Blockade on Endothelium-Dependent Relaxation Response of Coronary Segments Distal to Stents
In the presence of nitric oxide synthetase inhibitor L-NAME, relaxations to endothelium-dependent receptor-mediated vasodilator agonist substance P were inhibited to a greater degree in BMS (A) than in POLY (B) than in SES (C) (*p < 0.05, #p < 0.01). Abbreviations as in Figures 2 and 3.
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