Author + information
- Received June 18, 2010
- Revision received August 16, 2010
- Accepted August 20, 2010
- Published online February 1, 2011.
- Takamitsu Nakamura, MD, PhD⁎,
- Brigitta C. Brott, MD†,
- Irena Brants, DVM⁎,
- Deepal Panchal, MS⁎,
- Jinsheng Li, MD, PhD⁎,
- Jack P. Chen, MD⁎,
- Spencer B. King III, MD⁎,
- Nicolas Chronos, MD⁎ and
- Dongming Hou, MD, PhD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Dongming Hou, Saint Joseph's Translational Research Institute/Saint Joseph's Hospital of Atlanta, 380-B Northyards Boulevard, Atlanta, Georgia 30313
Objectives The purpose of this study was to evaluate endothelial function after post-dilation of bare-metal stents with paclitaxel-coated balloons (PCB) or non–drug-coated balloons (non-DCB) in a porcine model.
Background DCB are an attractive alternative to drug-eluting stents because they provide short duration of drug exposure, while potentially inhibiting in-stent restenosis. Drug-eluting stents are associated with impaired endothelial function. It is unknown whether this abnormal vasomotor function is mitigated by reduced duration of drug exposure.
Methods Thirteen pigs underwent bare-metal stent implantation (arteries, n = 30), followed by post-dilation with either PCB (SeQuent Please, B. Braun Melsungen AG, Berlin, Germany) (n = 17) or non-DCB (n = 13). Five pigs with unstented arteries (n = 14) were controls. Coronary vasomotion was assessed 1 month after stent implantation, using acetylcholine (Ach) and nitroglycerin. Measurements were obtained for distal segments.
Results Angiographic late loss and histological area stenosis were similar between PCB and non-DCB. However, the percentage of diameter change in response to Ach was diminished with PCB (p < 0.05), when compared with either non-DCB or naive arteries. There was no difference between non-DCB and naive arteries. Inflammatory score and intramural fibrin grading were significantly greater in PCB than non-DCB (p < 0.05). Additionally, inflammatory cell infiltration in the stented segments correlated with the degree of percentage of diameter change in response to Ach, at distal regions.
Conclusions Post-dilation of bare-metal stents with PCB was associated with impaired vasodilatory response to Ach distal to the treated segments. Vasodilatory response after post-dilation with non-DCB was similar to control arteries.
The authors have reported that they have no relationships to disclose. Eric Bates, MD, served as Guest Editor for this paper.
- Received June 18, 2010.
- Revision received August 16, 2010.
- Accepted August 20, 2010.
- American College of Cardiology Foundation