Neoatherosclerosis development following bioresorbable vascular scaffold implantation in diabetic and non-diabetic swine.

<h4>Background</h4>DM remains a risk factor for poor outcome after stent-implantation, but little is known if and how DM affects the vascular response to BVS.<h4>Aim</h4>The aim of our study was to examine coronary responses to bioresorbable vascular scaffolds (BVS) in swine...

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Main Authors: Nienke S van Ditzhuijzen, Mie Kurata, Mieke van den Heuvel, Oana Sorop, Richard W B van Duin, Ilona Krabbendam-Peters, Jurgen Ligthart, Karen Witberg, Magdalena Murawska, Brett Bouma, Martin Villiger, Hector M Garcia-Garcia, Patrick W Serruys, Felix Zijlstra, Gijs van Soest, Dirk-Jan Duncker, Evelyn Regar, Heleen M M van Beusekom
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0183419&type=printable
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Summary:<h4>Background</h4>DM remains a risk factor for poor outcome after stent-implantation, but little is known if and how DM affects the vascular response to BVS.<h4>Aim</h4>The aim of our study was to examine coronary responses to bioresorbable vascular scaffolds (BVS) in swine with and without diabetes mellitus fed a 'fast-food' diet (FF-DM and FF-NDM, respectively) by sequential optical coherence tomography (OCT)-imaging and histology.<h4>Methods</h4>Fifteen male swine were evaluated. Eight received streptozotocin-injection to induce DM. After 9 months (M), 32 single BVS were implanted in epicardial arteries with a stent to artery (S/A)-ratio of 1.1:1 under quantitative coronary angiography (QCA) and OCT guidance. Lumen, scaffold, neointimal coverage and composition were assessed by QCA, OCT and near-infrared spectroscopy (NIRS) pre- and/or post-procedure, at 3M and 6M. Additionally, polarization-sensitive (PS)-OCT was performed in 7 swine at 6M. After sacrifice at 3M and 6M, histology and polymer degradation analysis were performed.<h4>Results</h4>Late lumen loss was high (~60%) within the first 3M after BVS-implantation (P<0.01 FF-DM vs. FF-NDM) and stabilized between 3M and 6M (<5% change in FF-DM, ~10% in FF-NDM; P>0.20). Neointimal coverage was highly heterogeneous in all swine (DM vs. NDM P>0.05), with focal lipid accumulation, irregular collagen distribution and neointimal calcification. Likewise, polymer mass loss was low (~2% at 3M, ~5% at 6M;P>0.20) and not associated with DM or inflammation.<h4>Conclusion</h4>Scaffold coverage showed signs of neo-atherosclerosis in all FF-DM and FF-NDM swine, scaffold polymer was preserved and the vascular response to BVS was not influenced by diabetes.
ISSN:1932-6203