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Figini F, Manjunath CN, Srinivas BC, Sadananda KS, Sreedharan M, Fischer L, Pillai R, Varghese K, Gopal AK, Nagesh CM, Sheiban I. Long-term results of a sirolimus-eluting stent with biodegradable polymer (RAPSTROM™) in de novo coronary stenoses. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2017; 19:429-432. [PMID: 29174500 DOI: 10.1016/j.carrev.2017.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/02/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To report long-term results of a novel sirolimus-eluting stent with biodegradable polymer BACKGROUND: Newer generation drug-eluting stents are characterized by thin struts, improved platform design and highly biocompatible polymer carrying the antiproliferative drug. The RapstromTM stent, sharing these features, showed promising outcomes in preclinical models and in a first-in-man trial. METHODS The present study is a multicenter, non-randomized post-market registry, including patients with de novo coronary artery disease treated with implantation of one or more Rapstrom stents. Primary endpoint of the study was the rate of major adverse cardiac events (MACE) at three-year follow-up. RESULTS 1073 patients were enrolled, with a high prevalence of diabetes (35%) and acute coronary syndrome at presentation (82%); at three-year follow up, MACE rate was 14.8%, with a low incidence of definite or probable stent thrombosis (0.75%). CONCLUSIONS These data confirm the good clinical performance of the Rapstrom stent, supporting the concept that the combination of thin struts and biodegradable polymer is associated with positive clinical outcomes.
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Sojitra P, Doshi M, Galloni M, Vignolini C, Vyas A, Chevli B, Sheiban I. Preclinical evaluation of a novel abluminal surface coated sirolimus eluting stent with biodegradable polymer matrix. Cardiovasc Diagn Ther 2015; 5:254-63. [PMID: 26331109 DOI: 10.3978/j.issn.2223-3652.2015.06.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 05/11/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Second generation of drug eluting stents (DES) has attempted to improve safety using abluminal sirolimus drug delivery with biodegradable polymers matrix. The present preclinical study was designed to investigate the safety and efficacy profile of Abluminus™ stents (SES). This is a new coronary stent with sirolimus and biodegradable polymer matrix coated on abluminal stent and balloon surface. METHODS SES were compared with two controls: bare metal stent (BMS) and BMS + polymer coated stents (PC). All devices (40 stents) were implanted in porcine coronary arteries with primary endpoint of endothelialization at 7 days and subsequent histological and morphometric evaluations at 7, 30 and 90 days. RESULTS Early endothelialization at seven days was complete in all stents. Histology at 30 days revealed minimum inflammation in all groups and increased at 90 days in PC group while it was absent at 180 days. Thirty day morphometry showed significantly reduction of neointimal area in Abluminus™ (SES 0.96±0.48 mm(2); BMS 1.83±0.34 mm(2); PC 1.76±0.55 mm(2); P<0.05); after 90 days neointimal area was 1.10±0.54 mm(2) for SES; 1.92±0.36 mm(2) for BMS; and 1.94±0.48 mm(2) for PC; P<0.05). Neointimal thickness at 30 and 90 days respectively was 0.15±0.07 and 0.18±0.10 mm for SES, 0.57±0.08 and 0.61±0.09 mm for BMS and 0.52±0.09 and 0.59±0.08 mm, P<0.001 for PC group. CONCLUSIONS The most significant experimental evidence appears to be earlier endothelialization at 7 days for SES which led to safety of the device. Efficacy of the device was also observed by a reduced neointimal thickness and minimized inflammatory score at all follow-ups. Termination of antiplatelet at 30 days has not shown any further complications. Polymer thickness was almost in negligible amount at 180 days with no inflammation.
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Affiliation(s)
- Prakash Sojitra
- 1 Envision Scientific Private Limited, Surat, Gujarat 395001, India ; 2 Life and Device S.r.l., Spin-Off of University of Turin, Turin, Italy ; 3 University of Turin, Turin, Torino, Italy
| | - Manish Doshi
- 1 Envision Scientific Private Limited, Surat, Gujarat 395001, India ; 2 Life and Device S.r.l., Spin-Off of University of Turin, Turin, Italy ; 3 University of Turin, Turin, Torino, Italy
| | - Marco Galloni
- 1 Envision Scientific Private Limited, Surat, Gujarat 395001, India ; 2 Life and Device S.r.l., Spin-Off of University of Turin, Turin, Italy ; 3 University of Turin, Turin, Torino, Italy
| | - Christina Vignolini
- 1 Envision Scientific Private Limited, Surat, Gujarat 395001, India ; 2 Life and Device S.r.l., Spin-Off of University of Turin, Turin, Italy ; 3 University of Turin, Turin, Torino, Italy
| | - Ashwin Vyas
- 1 Envision Scientific Private Limited, Surat, Gujarat 395001, India ; 2 Life and Device S.r.l., Spin-Off of University of Turin, Turin, Italy ; 3 University of Turin, Turin, Torino, Italy
| | - Bhavesh Chevli
- 1 Envision Scientific Private Limited, Surat, Gujarat 395001, India ; 2 Life and Device S.r.l., Spin-Off of University of Turin, Turin, Italy ; 3 University of Turin, Turin, Torino, Italy
| | - Imad Sheiban
- 1 Envision Scientific Private Limited, Surat, Gujarat 395001, India ; 2 Life and Device S.r.l., Spin-Off of University of Turin, Turin, Italy ; 3 University of Turin, Turin, Torino, Italy
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