Author + information
- Received September 21, 2015
- Revision received December 1, 2015
- Accepted December 11, 2015
- Published online April 11, 2016.
- Bill D. Gogas, MD, PhDa,b,
- James J. Benham, BSc,
- Steve Hsu, PhDc,
- Alexander Sheehy, MSc,
- David J. Lefer, PhDd,
- Traci T. Goodchild, PhDd,
- David J. Polhemus, BAd,
- Yasir H. Bouchi, BSb,
- Olivia Y. Hung, MD, PhDa,b,
- Sang-Yong Yoo, MD, PhDa,b,e,
- Udit Joshi, MDb,
- Don P. Giddens, PhDb,f,
- Alessandro Veneziani, PhDb,g,
- Arshed Quyyumi, MDh,
- Richard Rapoza, PhDc,
- Spencer B. King III, MDa,b,i and
- Habib Samady, MDa,b,∗ ()
- aAndreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- bEmory Cardiovascular Imaging & Biomechanics Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
- cAbbott Vascular, Santa Clara, California
- dLouisiana State University Health Sciences Center, New Orleans, Louisiana
- eGangneung Asan Hospital, Ulsan University College of Medicine, Ulsan, South Korea
- fWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
- gDepartment of Mathematics and Computer Science, Emory University, Atlanta, Georgia
- hEmory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
- iSaint Joseph’s Heart and Vascular Institute, Atlanta, Georgia
- ↵∗Reprint requests and correspondence:
Dr. Habib Samady, Emory University School of Medicine, 1364 Clifton Road NE, Suite F622, Atlanta, Georgia 30322.
Objectives The purpose of this study was to assess and compare in vivo the restoration of vasomotor function following Absorb bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) and metallic Xience V (XV) (Abbott Vascular, Santa Clara, California) stent implantations in porcine coronary arteries at 1 and 2 years.
Background Drug-eluting metallic coronary stents induce sustained vasomotor dysfunction, and preliminary observations from arteries with bioresorbable scaffolds have indicated partially restored vasoreactivity.
Methods A total of 15 Absorb BVS (3.0 × 18.0 mm) and 14 XV (3.0 × 18.0 mm or 3.0 × 12.0 mm) stents were randomly implanted in the main coronaries of 12 nonatherosclerotic swine. The effect of implant on vasomotor performance (constrictive and expansive) was measured in the stented/scaffolded segments and the 5-mm proximal and distal adjacent segments in vivo by angiography assessing mean luminal diameter changes following infusion of vasoactive agents at 1 year (n = 6) and 2 years (n = 6) as well as ex vivo at 2 years using a tissue chamber apparatus. Endothelial cell function and smooth muscle cell phenotype gene marker levels were evaluated with quantitative real-time polymerase chain reaction.
Results The scaffolded Absorb BVS segments showed fully restored constrictive response compared with XV implanted vessels at 1 year: −24.30 ± 14.31% versus −1.79 ± 6.57% (p < 0.004) and at 2 years: −28.13 ± 14.60% versus −3.90 ± 6.44% (p < 0.004). The early restoration of vasomotor function within the scaffolded segments reached a peak at 1 year and did not significantly change up to 2 years. The vasoactive responses of Absorb BVS-implanted vessels within the scaffolded segments were similar to those observed within the proximal and distal edge segments at both time points. Conversely, the stented XV segments demonstrated significantly impaired constrictive response compared with the distal XV edges at 1 year: −1.79 ± 6.57% versus −21.89 ± 7.17% (p < 0.0002) and at 2 years: −3.90 ± 6.44% versus −21.93 ± 15.60% (p < 0.03). Ex vivo assessment of contraction induced by PGF2α and relaxation induced by substance P of isolated BVS segments compared with XV-treated segments generated greater contraction force of 3.94 ± 0.97 g versus 1.83 ± 1.03 g (p < 0.05), and endothelial-dependent relaxation reached 35.91 ± 24.74% versus 1.20 ± 3.79% (p < 0.01). Quantitative real-time polymerase chain reaction gene analysis at 2 years demonstrated increased Connexin 43 messenger ribonucleic acid levels of Absorb BVS-treated vessels compared with XV-treated vessels: 1.92 ± 0.23 versus 0.77 ± 12 (p < 0.05).
Conclusions Absorb BVS-implanted coronary arteries demonstrate early functional restoration of the scaffolded and adjacent segments at 1 year, which is preserved up to 2 years.
Drs. Benham, Hsu, Sheehy, and Rapoza are employees of Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Gogas and Benham contributed equally to this work.
- Received September 21, 2015.
- Revision received December 1, 2015.
- Accepted December 11, 2015.
- American College of Cardiology Foundation