돼지 관상동맥 스텐트 재협착 모델에서 Carvedilol 부착BiodivYsioTM 스텐트의 신생내막 증식 억제 효과
The effect of the carvedilol-loaded BiodivYsioTM DD stent on the inhibition of neointimal proliferation in a porcine coronary stent restenosis model
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Abstract
Background : Carvedilol is a beta- and alpha-receptor blocker, a direct inhibitor of smooth muscle cell proliferation and migration, and produces a significant suppression of neointimal hyperplasia in rat carotid injury model. We tested whether carvedilol stent coating is effective in preventing neointimal formation in a porcine model of stent restenosis. Methods : BiodivYsio phosphorylcholine-coated stents were dip-coated with carvedilol at the concentrations of 0, 7, 96 and 154 µg/stent by the immersion in a methanolic carvedilol followed by the evaporation of the solvent. Thirty-two stents, 8 stents per each concentration, were deployed in the porcine coronary arteries. The treatment effect was assessed at 28 days after stent implantation. Results : Angiographic minimal lumen diameter and late loss index were similar among the four groups. On histomorphometry, neointimal area decreased by 58% and lumen area increased by 20%, resulting in a 58% reduction of percent in-stent stenosis in 7 µg carvedilol/stent (p=0.002, 0.008 and 0.004, respectively, 7 µg vs. 0 µg carvedilol/stent). Modest change in neointimal and lumen area was observed in 96 and 154 µg carvedilol/stent. A proliferating nuclear cell antigen-positive cells was noted 7.78±2.97% in 7 µg carvedilol/stent vs. 17.82±1.45% in 0 µg carvedilol/stent (p=0.0001). Conclusion : A Low dose carvedilol stent coating produces a significant inhibition of neointimal hyperplasia in a porcine model of stent restenosis. This study provides a potential therapeutic benefit of carvedilol coating in the prevention of human stent restenosis.
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