Comparison of inflammatory response after implantation of sirolimus- and paclitaxel-eluting stents in porcine coronary arteries
Wilson GJ et al. – A high prevalence in a porcine model of diffuse granulomatous inflammation with sirolimus (CYPHER) stents, persisting at 180 days and associated with extensive artery remodeling, and persistent para-strut fibrin deposition with paclitaxel (TAXUS) stents emphasize the need for further sudy of biocompatibility with these and other novel combination drug/polymer drug-eluting stents. Methods- Overlapping stents (CYPHER drug-eluting stents, Bx SONIC bare metal stents, TAXUS drug-eluting stents, Liberté bare metal stents) implanted in noninjured coronary arteries of 58 domestic swine
- Histopathologic study of proximal, overlapped, and distal stented segments
- Focus on inflammation at 30, 90, and 180 days
- Circumferential granulomatous inflammation in all stented segments defined as inflammation consisting of macrophages, multinucleated giant cells, lymphocytes, and granulocytes, including many eosinophils, adjacent to almost all struts
Results- Circumferential granulomatous inflammation more prevalent in CYPHER (9 of 23, 39%) vs TAXUS (1 of 21, 5%) and control bare metal stents (0 of 44) in combined 90- and 180-day cohorts
- Only CYPHER specimens showed marked adventitial inflammation and fibrosis with extensive remodeling
- Fibrin deposition within neointima and medial smooth muscle cell death greater in TAXUS vs CYPHER at 30 days, with more fibrin in TAXUS vs CYPHER through 90 days
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