1
|
Kitahara H, Okada K, Kimura T, Yock PG, Lansky AJ, Popma JJ, Yeung AC, Fitzgerald PJ, Honda Y. Impact of Stent Size Selection on Acute and Long-Term Outcomes After Drug-Eluting Stent Implantation in De Novo Coronary Lesions. Circ Cardiovasc Interv 2017; 10:CIRCINTERVENTIONS.116.004795. [DOI: 10.1161/circinterventions.116.004795] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 08/22/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Hideki Kitahara
- From the Stanford University School of Medicine, CA (H.K., K.O., T.K., P.G.Y., A.C.Y., P.J.F., Y.H.); Yale University School of Medicine, New Haven, CT (A.J.L.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Kozo Okada
- From the Stanford University School of Medicine, CA (H.K., K.O., T.K., P.G.Y., A.C.Y., P.J.F., Y.H.); Yale University School of Medicine, New Haven, CT (A.J.L.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Takumi Kimura
- From the Stanford University School of Medicine, CA (H.K., K.O., T.K., P.G.Y., A.C.Y., P.J.F., Y.H.); Yale University School of Medicine, New Haven, CT (A.J.L.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Paul G. Yock
- From the Stanford University School of Medicine, CA (H.K., K.O., T.K., P.G.Y., A.C.Y., P.J.F., Y.H.); Yale University School of Medicine, New Haven, CT (A.J.L.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Alexandra J. Lansky
- From the Stanford University School of Medicine, CA (H.K., K.O., T.K., P.G.Y., A.C.Y., P.J.F., Y.H.); Yale University School of Medicine, New Haven, CT (A.J.L.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Jeffrey J. Popma
- From the Stanford University School of Medicine, CA (H.K., K.O., T.K., P.G.Y., A.C.Y., P.J.F., Y.H.); Yale University School of Medicine, New Haven, CT (A.J.L.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Alan C. Yeung
- From the Stanford University School of Medicine, CA (H.K., K.O., T.K., P.G.Y., A.C.Y., P.J.F., Y.H.); Yale University School of Medicine, New Haven, CT (A.J.L.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Peter J. Fitzgerald
- From the Stanford University School of Medicine, CA (H.K., K.O., T.K., P.G.Y., A.C.Y., P.J.F., Y.H.); Yale University School of Medicine, New Haven, CT (A.J.L.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Yasuhiro Honda
- From the Stanford University School of Medicine, CA (H.K., K.O., T.K., P.G.Y., A.C.Y., P.J.F., Y.H.); Yale University School of Medicine, New Haven, CT (A.J.L.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| |
Collapse
|
2
|
Li Y, Chu Z, Li X, Ding X, Guo M, Zhao H, Yao J, Wang L, Cai Q, Fan Y. The effect of mechanical loads on the degradation of aliphatic biodegradable polyesters. Regen Biomater 2017; 4:179-190. [PMID: 28596915 PMCID: PMC5458542 DOI: 10.1093/rb/rbx009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/01/2017] [Accepted: 03/06/2017] [Indexed: 12/11/2022] Open
Abstract
Aliphatic biodegradable polyesters have been the most widely used synthetic polymers for developing biodegradable devices as alternatives for the currently used permanent medical devices. The performances during biodegradation process play crucial roles for final realization of their functions. Because physiological and biochemical environment in vivo significantly affects biodegradation process, large numbers of studies on effects of mechanical loads on the degradation of aliphatic biodegradable polyesters have been launched during last decades. In this review article, we discussed the mechanism of biodegradation and several different mechanical loads that have been reported to affect the biodegradation process. Other physiological and biochemical factors related to mechanical loads were also discussed. The mechanical load could change the conformational strain energy and morphology to weaken the stability of the polymer. Besides, the load and pattern could accelerate the loss of intrinsic mechanical properties of polymers. This indicated that investigations into effects of mechanical loads on the degradation should be indispensable. More combination condition of mechanical loads and multiple factors should be considered in order to keep the degradation rate controllable and evaluate the degradation process in vivo accurately. Only then can the degradable devise achieve the desired effects and further expand the special applications of aliphatic biodegradable polyesters.
Collapse
Affiliation(s)
- Ying Li
- School of Biological Science and Medical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, Beihang University, Beijing 100191, People’s Republic of China
| | - Zhaowei Chu
- School of Biological Science and Medical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, Beihang University, Beijing 100191, People’s Republic of China
| | - Xiaoming Li
- School of Biological Science and Medical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, Beihang University, Beijing 100191, People’s Republic of China
| | - Xili Ding
- School of Biological Science and Medical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, Beihang University, Beijing 100191, People’s Republic of China
| | - Meng Guo
- School of Biological Science and Medical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, Beihang University, Beijing 100191, People’s Republic of China
| | - Haoran Zhao
- Department of Biomedical Engineer, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Jie Yao
- School of Biological Science and Medical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, Beihang University, Beijing 100191, People’s Republic of China
| | - Lizhen Wang
- School of Biological Science and Medical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, Beihang University, Beijing 100191, People’s Republic of China
| | - Qiang Cai
- Key Laboratory of Advanced Materials of Ministry of Education of China, Tsinghua University, Beijing 100084, People’s Republic of China
| | - Yubo Fan
- School of Biological Science and Medical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, Beihang University, Beijing 100191, People’s Republic of China
- National Research Center for Rehabilitation Technical Aids, Beijing 100176, People’s Republic of China
| |
Collapse
|
3
|
Kitahara H, Waseda K, Yamada R, Sakamoto K, Yock PG, Fitzgerald PJ, Honda Y. Relative dose and vascular response after drug-eluting stent implantation: A dosimetric 3D-intravascular ultrasound study. Int J Cardiol 2016; 204:211-7. [PMID: 26681540 DOI: 10.1016/j.ijcard.2015.11.130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 11/19/2015] [Accepted: 11/22/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND In drug-eluting stents (DESs), the theoretical drug dose exposed to the vessel wall per stent surface area may vary due to the fixed loading dose and differences in the stent surface area once expanded in varying vessel sizes. The aim of this study was to evaluate the potential effects of different dose intensities, as estimated by 3D-IVUS dosimetry, on vascular response after DES implantation. METHODS Follow-up (6-9 months) 3D-IVUS was performed in 840 coronary lesions treated with a single DES of the following types: sirolimus (SES, n=148), paclitaxel (PES, n=162), Endeavor zotarolimus (E-ZES, n=233), Resolute zotarolimus (R-ZES, n=147), and everolimus (EES, n=150). Volume index (volume/length, mm(3)/mm) was obtained for vessel, lumen, plaque, stent, and neointima. In each lesion, exposed dose intensity was calculated as known loading dose divided by measured luminal surface area of the stented segment. Lesions were divided into tertiles based on the exposed dose intensity: high, medium, and low dose groups. RESULTS The exposed dose intensity ranged 0.74-1.76 μg/mm(2) for SES, 0.41-1.18 μg/mm(2) for PES, 0.71-1.57 μg/mm(2) for E-ZES, 0.72-1.63 μg/mm(2) for R-ZES, and 0.40-0.99 μg/mm(2) for EES. All types of DES showed no significant difference in neointimal hyperplasia among the 3 groups, except that E-ZES showed significantly less neointimal hyperplasia in the high dose group. CONCLUSIONS Detailed 3D-IVUS revealed significant lesion-to-lesion variability in dose intensity exposed to the vessel wall following DES implantation. However, the major types of DES appear to yield equally effective neointimal suppression, despite the varying dose intensity, except for E-ZES.
Collapse
Affiliation(s)
- Hideki Kitahara
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Katsuhisa Waseda
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Ryotaro Yamada
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Kenji Sakamoto
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Paul G Yock
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Peter J Fitzgerald
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Yasuhiro Honda
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States.
| |
Collapse
|
10
|
Waseda K, Ako J, Yamasaki M, Koizumi T, Sakurai R, Hongo Y, Koo BK, Ormiston J, Worthley SG, Whitbourn RJ, Walters DL, Meredith IT, Fitzgerald PJ, Honda Y. Impact of Polymer Formulations on Neointimal Proliferation After Zotarolimus-Eluting Stent With Different Polymers. Circ Cardiovasc Interv 2011; 4:248-55. [DOI: 10.1161/circinterventions.110.957548] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Polymer formulation may affect the efficacy of drug-eluting stents. Resolute, Endeavor, and ZoMaxx are zotarolimus-eluting stents with different stent platforms and different polymer coatings and have been tested in clinical trials. The aim of this analysis was to compare the efficacy of zotarolimus-eluting stents with different polymers.
Methods and Results—
Data were obtained from the first-in man trial or first randomized trials of each stent, The Clinical RESpOnse EvaLUation of the MedTronic Endeavor CR ABT-578 Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions (RESOLUTE), Randomized Controlled Trial to Evaluate the Safety and Efficacy of the Medtronic AVE ABT-578 Eluting Driver Coronary Stent in De Novo Native Coronary Artery Lesions (ENDEAVOR II), and ZoMaxx I trials. Follow-up intravascular ultrasound analyses (8 to 9 months of follow-up) were possible in 353 patients (Resolute: 88, Endeavor: 98, ZoMaxx: 82, Driver: 85). Volume index (volume/stent length) was obtained for vessel, stent, lumen, peristent plaque, and neointima. Cross-sectional narrowing was defined as neointimal area divided by stent area (%). Neointima-free frame ratio was calculated as the number of frames without intravascular ultrasound–detectable neointima divided by the total number of frames within the stent. At baseline, vessel, lumen, and peristent plaque volume index were not significantly different among the 4 stent groups. At follow-up, percent neointimal obstruction was significantly lower in Resolute compared with Endeavor, ZoMaxx, and Driver (Resolute: 3.7±4.0, Endeavor: 17.5±10.1, ZoMaxx: 14.6±8.1, Driver: 29.4±17.2%;
P
<0.001). Greater maximum cross-sectional narrowing and higher neointima-free frame ratio, suggesting less neointimal coverage, were observed in Resolute compared with other stent groups. Multiple regression analysis confirmed that the biodurable polymer used in Resolute independently correlated with neointimal suppression among 3 zotarolimus-eluting stents.
Conclusions—
The different polymer formulations significantly affect the relative amount of neointima for zotarolimus-eluting stents.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00248079.
Collapse
Affiliation(s)
- Katsuhisa Waseda
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Junya Ako
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Masao Yamasaki
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Tomomi Koizumi
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Ryota Sakurai
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Yoichiro Hongo
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Bon-Kwon Koo
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - John Ormiston
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Stephen G. Worthley
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Robert J. Whitbourn
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Darren L. Walters
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Ian T. Meredith
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Peter J. Fitzgerald
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| | - Yasuhiro Honda
- From Stanford University, Stanford, CA (K.W., J.A., M.Y., T.K., R.S., Y. Hongo, B.-K.K., P.J.F., Y. Honda); Auckland City Hospital, Auckland, New Zealand (J.O.); Royal Adelaide Hospital, Adelaide, Australia (S.G.W.); St Vincent's Hospital, Melbourne, Australia (R.J.W.); Prince Charles Hospital, Brisbane, Australia (D.L.W.); and Monash Heart and Medical Centre, Clayton, Australia (I.T.M.)
| |
Collapse
|