Title:Preclinical Evaluation of Coronary Stents: Focus on Safety Issues
Volume: 11
Issue: 1
Author(s): Armando Perez de Prado, Claudia Perez-Martinez, Carlos Cuellas, Jose M. Gonzalo-Orden, Alejandro Diego, Marta Regueiro, Beatriz Martinez-Fernandez, Jose R. Altonaga, J. Francisco G. Marin and Felipe Fernandez-Vazquez
Affiliation:
Keywords:
Animal model, drug eluting stent, endothelium, inflammation, percutaneous coronary intervention, safety, stent
thrombosis vascular healing
Abstract: In recent years, we have witnessed a revolution in the treatment of coronary artery disease. The development
and improvement of drug eluting stents (DES) have lowered the incidence of restenosis to one-digit figures. In the search
for a superior efficacy, animal models have played a key role. The classical swine model of coronary stenting remains the
preferred model to measure restenosis, although the rabbit iliac artery stenting has become an accepted alternative. After
widespread clinical use of DES, an unforeseen complication arose: late stent thrombosis. In a back-to-bench step, some
data from animal models helped to explain the phenomenon. A delayed and incomplete vascular healing was detected.
Toxic and hypersensitivity reactions to polymers and/or drugs seem to be the underlying causes. So, translational research
focused on the safety aspect of these devices: development of better drug carriers as absorbable polymers or fully bioresorbable
scaffolds, selection of different drugs and assessment of the re-endothelialization process. We review and evaluate
the efficacy and safety of coronary stents in different animal models. Further improvements in this field such as, the
selection of better animal models (e.g. hyperlipidemic, diabetic, atherosclerotic) that closely mimic the clinical setting and
longer follow-up periods to detect late complications are also discussed.
