Stent Thrombogenicity Early in High-Risk Interventional Settings Is Driven by Stent Design and Deployment and Protected by Polymer-Drug Coatings
被引:652
作者:
Kolandaivelu, Kumaran
论文数: 0引用数: 0
h-index: 0
机构:
Harvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Cardiovasc, Boston, MA 02115 USAHarvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Kolandaivelu, Kumaran
[1
,2
]
Swaminathan, Rajesh
论文数: 0引用数: 0
h-index: 0
机构:
Harvard MIT Div Hlth Sci & Technol, Cambridge, MA USAHarvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Swaminathan, Rajesh
[1
]
Gibson, William J.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard MIT Div Hlth Sci & Technol, Cambridge, MA USAHarvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Gibson, William J.
[1
]
Kolachalama, Vijaya B.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard MIT Div Hlth Sci & Technol, Cambridge, MA USAHarvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Kolachalama, Vijaya B.
[1
]
Nguyen-Ehrenreich, Kim-Lien
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAHarvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Nguyen-Ehrenreich, Kim-Lien
[3
]
Giddings, Virginia L.
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAHarvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Giddings, Virginia L.
[3
]
Coleman, Leslie
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAHarvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Coleman, Leslie
[3
]
Wong, Gee K.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Concord Biomed Sci & Emerging Technol, Lexington, MA USAHarvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Wong, Gee K.
[1
,4
]
Edelman, Elazer R.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Cardiovasc, Boston, MA 02115 USAHarvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
Edelman, Elazer R.
[1
,2
]
机构:
[1] Harvard MIT Div Hlth Sci & Technol, Cambridge, MA USA
[2] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Cardiovasc, Boston, MA 02115 USA
[3] Abbott Vasc, Santa Clara, CA USA
[4] Concord Biomed Sci & Emerging Technol, Lexington, MA USA
Background-Stent thrombosis is a lethal complication of endovascular intervention. Concern has been raised about the inherent risk associated with specific stent designs and drug-eluting coatings, yet clinical and animal support is equivocal. Methods and Results-We examined whether drug-eluting coatings are inherently thrombogenic and if the response to these materials was determined to a greater degree by stent design and deployment with custom-built stents. Drug/polymer coatings uniformly reduce rather than increase thrombogenicity relative to matched bare metal counterparts (0.65-fold; P=0.011). Thick-strutted (162 mu m) stents were 1.5-fold more thrombogenic than otherwise identical thin-strutted (81 mu m) devices in ex vivo flow loops (P<0.001), commensurate with 1.6-fold greater thrombus coverage 3 days after implantation in porcine coronary arteries (P=0.004). When bare metal stents were deployed in malapposed or overlapping configurations, thrombogenicity increased compared with apposed, length-matched controls (1.58-fold, P=0.001; and 2.32-fold, P<0.001). The thrombogenicity of polymer-coated stents with thin struts was lowest in all configurations and remained insensitive to incomplete deployment. Computational modeling-based predictions of stent-induced flow derangements correlated with spatial distribution of formed clots. Conclusions-Contrary to popular perception, drug/polymer coatings do not inherently increase acute stent clotting; they reduce thrombosis. However, strut dimensions and positioning relative to the vessel wall are critical factors in modulating stent thrombogenicity. Optimal stent geometries and surfaces, as demonstrated with thin stent struts, help reduce the potential for thrombosis despite complex stent configurations and variability in deployment. (Circulation. 2011;123:1400-1409.)
机构:
Columbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Columbia Univ, Med Ctr, New York Presbyterian Hosp, New York, NY USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Stone, Gregg W.
Rizvi, Ali
论文数: 0引用数: 0
h-index: 0
机构:
Heart Ctr Indiana, Indianapolis, IN USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Rizvi, Ali
Newman, William
论文数: 0引用数: 0
h-index: 0
机构:
Wake Med Ctr, Raleigh, NC USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Newman, William
Mastali, Kourosh
论文数: 0引用数: 0
h-index: 0
机构:
St Joseph Med Ctr, Towson, MD USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Mastali, Kourosh
Wang, John C.
论文数: 0引用数: 0
h-index: 0
机构:
Union Mem Hosp, Baltimore, MD USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Wang, John C.
Caputo, Ronald
论文数: 0引用数: 0
h-index: 0
机构:
St Josephs Hosp Syracuse, Syracuse, NY USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Caputo, Ronald
Doostzadeh, Julie
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Doostzadeh, Julie
Cao, Sherry
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Cao, Sherry
Simonton, Charles A.
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Simonton, Charles A.
Sudhir, Krishnankutty
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Sudhir, Krishnankutty
Lansky, Alexandra J.
论文数: 0引用数: 0
h-index: 0
机构:
Columbia Univ, Med Ctr, New York Presbyterian Hosp, New York, NY USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Lansky, Alexandra J.
Cutlip, Donald E.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Clin Res Inst, Boston, MA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Cutlip, Donald E.
Kereiakes, Dean J.
论文数: 0引用数: 0
h-index: 0
机构:
Christ Hosp, Heart & Vasc Ctr, Lindner Res Ctr, Cincinnati, OH 45219 USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
机构:
Penn State Univ, Dept Mat Sci & Engn, University Pk, PA 16802 USA
Penn State Univ, Dept Bioengn, University Pk, PA 16802 USAPenn State Univ, Dept Mat Sci & Engn, University Pk, PA 16802 USA
Vogler, Erwin A.
Siedlecki, Christopher A.
论文数: 0引用数: 0
h-index: 0
机构:
Penn State Univ, Dept Bioengn, University Pk, PA 16802 USA
Penn State Univ, Dept Surg, Coll Med, Inst Biomed Engn, Hershey, PA 17033 USAPenn State Univ, Dept Mat Sci & Engn, University Pk, PA 16802 USA
机构:
Univ Liverpool, Liverpool L69 3BX, Merseyside, England
Tsinghua Univ, Beijing 100084, Peoples R ChinaUniv Liverpool, Liverpool L69 3BX, Merseyside, England
机构:
Columbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Columbia Univ, Med Ctr, New York Presbyterian Hosp, New York, NY USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Stone, Gregg W.
Rizvi, Ali
论文数: 0引用数: 0
h-index: 0
机构:
Heart Ctr Indiana, Indianapolis, IN USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Rizvi, Ali
Newman, William
论文数: 0引用数: 0
h-index: 0
机构:
Wake Med Ctr, Raleigh, NC USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Newman, William
Mastali, Kourosh
论文数: 0引用数: 0
h-index: 0
机构:
St Joseph Med Ctr, Towson, MD USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Mastali, Kourosh
Wang, John C.
论文数: 0引用数: 0
h-index: 0
机构:
Union Mem Hosp, Baltimore, MD USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Wang, John C.
Caputo, Ronald
论文数: 0引用数: 0
h-index: 0
机构:
St Josephs Hosp Syracuse, Syracuse, NY USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Caputo, Ronald
Doostzadeh, Julie
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Doostzadeh, Julie
Cao, Sherry
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Cao, Sherry
Simonton, Charles A.
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Simonton, Charles A.
Sudhir, Krishnankutty
论文数: 0引用数: 0
h-index: 0
机构:
Abbott Vasc, Santa Clara, CA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Sudhir, Krishnankutty
Lansky, Alexandra J.
论文数: 0引用数: 0
h-index: 0
机构:
Columbia Univ, Med Ctr, New York Presbyterian Hosp, New York, NY USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Lansky, Alexandra J.
Cutlip, Donald E.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Clin Res Inst, Boston, MA USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
Cutlip, Donald E.
Kereiakes, Dean J.
论文数: 0引用数: 0
h-index: 0
机构:
Christ Hosp, Heart & Vasc Ctr, Lindner Res Ctr, Cincinnati, OH 45219 USAColumbia Univ, Med Ctr, Cardiovasc Res Fdn, New York, NY 10022 USA
机构:
Penn State Univ, Dept Mat Sci & Engn, University Pk, PA 16802 USA
Penn State Univ, Dept Bioengn, University Pk, PA 16802 USAPenn State Univ, Dept Mat Sci & Engn, University Pk, PA 16802 USA
Vogler, Erwin A.
Siedlecki, Christopher A.
论文数: 0引用数: 0
h-index: 0
机构:
Penn State Univ, Dept Bioengn, University Pk, PA 16802 USA
Penn State Univ, Dept Surg, Coll Med, Inst Biomed Engn, Hershey, PA 17033 USAPenn State Univ, Dept Mat Sci & Engn, University Pk, PA 16802 USA
机构:
Univ Liverpool, Liverpool L69 3BX, Merseyside, England
Tsinghua Univ, Beijing 100084, Peoples R ChinaUniv Liverpool, Liverpool L69 3BX, Merseyside, England