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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2011, Vol. 5 Issue (4) : 395-400     DOI: 10.1007/s11684-011-0167-1
REVIEW |
Translational research on novel drug-eluting stents in percutaneous coronary intervention
Yaling Han(), Kai Xu, Chenghui Yan
Department of Cardiology, General Hospital of Shenyang Military Region, PLA, Shenyang 110840, China
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Abstract  

Although first-generation drug-eluting stents (DES) have markedly reduced restenosis, complications of late and very late in-stent thrombosis have emerged as prime limitations to this technology. The development of new DES is a key process to prevent these complications. Translational research plays a very important role in experiments which determine the safety and efficacy of DES before human clinical trials. The present review focuses on translational research of novel DES, including drug discovery, creation of preclinical research models, planning and conducting of first-in-man studies, and developing next-generation DES systems.

Keywords translational research      drug-eluting stents      percutaneous coronary intervention     
Corresponding Authors: Han Yaling,Email:hanyaling@263.net   
Issue Date: 05 December 2011
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-011-0167-1     OR     http://academic.hep.com.cn/fmd/EN/Y2011/V5/I4/395
DrugPropertiesPre-clinical model or patient enrollmentPerformance
Cerivastatin3-Hydroxy-3-methylglutaryl-CoA reductase inhibitorRat carotid stent modelEfficient limitation of neointima formation [6]
BatimastatAntimigratory drugRabbit iliac modelReduction of neo-intimal hyperplasia without delaying the healing process of the vessel [7]
FlavopiridolSynthetic cyclin-dependent kinase inhibitorRat carotid stent modelSignificant reduction of neointima formation [8]
CarvedilolAntioxidantsPorcine coronary restenosis modelInhibition of neointimal hyperplasia in a porcine stent restenosis model [9]
Cilostazol (plus paclitaxel)Phosphodiesterase inhibitorPatients undergoing percutaneous coronary intervention for de novo coronary artery lesionsSignificant reduction of the primary endpoint (late lumen loss as a marker of restenosis) [11]
Tab.1  Overview of potential drugs used in DES translational research
ModelPorcine coronary arteries modelRabbit iliac arteries model
EndothelializationFastSlow
Foam cellsRareRich
InflammationExtensiveNot extensive
AdvantagesResponds similar to human coronary arteriesProvides additional data, especially regarding endothelialization
DisadvantagesInjury models vary more widely in biologic response, thus affecting reliability and reproducibility of the evaluationVessels are smaller and the reaction to injury is less defined
Tab.2  Advantages and disadvantages of rabbit iliac arteries model versus porcine coronary arteries model
Fig.1  Adenovirus-mediated cellular repressor of E1A genes transferred to the balloon-injured artery and inhibited intimal hyperplasia (a and a'). In these representative micrographs of arterial sections stained with hematoxylin and eosin, the arrowheads define the neointima. The areas of the neointima and the media in the cross-sections of the artery were measured morphometrically and then plotted. The neointima area and the intima/media ratio of adenovirus-CREG-transduced arteries were much smaller than those of the no treatment saline (NT) and adenovirus green fluorescent protein (Ad-GFP) controls 28 days after balloon injury (<0.01); = 5 for each group (b and b'). Angiography of common carotid arteries was performed in the Ad-CREG, Ad-GFP, and saline-treated groups. The arrows define the minimal lumen diameter. The diameter stenosis rate of Ad-CREG-transduced arteries was significantly reduced compared with those of NT and Ad-GFP groups 28 days after vascular injury (<0.01); = 5 for each group (b'). Data are presented with the standard deviation.
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