Effect of a Novel Stent on Re-Endothelialization, Platelet Adhesion, and Neointimal Formation

Aim: Vascular endothelial-cadherin (VE-cadherin) is specifically expressed by outgrowth endothelial cells (OECs). Zwitterionic stent showed high antifouling and excellent blood compatibility. Therefore, we hypothesized that anti-VE-cadherin antibody-coated zwitterionic stents (VE-cad-Z stents) would promote re-endothelialization, reduce neointimal formation, and resist thrombus. Methods: VE-cad-Z stents were examined using platelet adhesion test, platelet activation, and OEC capture ability in vitro. In vivo effect of VE-cad-Z stents on re-endothelialization, thrombus-resistance, and neointima hyperplasia was investigated in left common carotid arteries of rabbits (n = 15). Results: In vitro, VE-cad-Z stents showed better platelet-resistance and OEC-capture ability (DNA concentration: 297.23 +/- 22.71 versus 67.49 +/- 15.26 ng/mu L, P< 0.01). In vivo, VE-cad-Z stents exhibited better patency rate than bare metal stents (BMS) (15/15 versus 12/15), and it significantly reduced platelet adhesion and neointima formation (neointima area: 1.13 +/- 0.05 versus 1.00 +/- 0.05 mm(2), P < 0.01 and 3.04 +/- 0.11 versus 1.05 +/- 0.06 mm(2), P < 0.01, at 3 and 30 days, respectively; % stenosis: 20.99 +/- 0.98 versus 18.72 +/- 0.97, P < 0.01 and 56.46 +/- 2.20 versus 19.45 +/- 1.24, P < 0.01, at 3 and 30 days, respectively). Conclusion: These data suggested that VE-cad-Z stents could specifically capture OECs, consequently promote endothelial healing, and also reduce platelet adhesion and neointima formation.