Advances in experimental models of coronary artery disease: Towards alternatives for animal models

Research output: Types of ThesisDoctoral ThesisInternal


The interaction between humans and animals is characterized by ambivalence. While there exists a deep connection between humans and animals, humans frequently use animals for their own interests. This ambivalence leads to ethical dilemmas on the use of animals in areas like food production, sports, health and scientific research. To promote the development of methods to reduce the use of animals for the development of medicines and medical treatments, the Dutch government body ZonMw initiated the MKMD program, which stands for “Meer Kennis met Minder Dieren” or “More Knowledge with Fewer Animals”. The research presented in this thesis was conducted within the framework of the MKMD program. It specifically delves into advances in experimental models of coronary artery disease (CAD), with a particular focus on methods capable of reducing, replacing and refining the use of experimental animal models. This aspect holds significance due to the widespread prevalence of CAD as a leading cause of mortality and a substantial global health burden.
While pharmaceutical interventions and medical procedures like stenting are common approaches to CAD treatment, the occurrence of complications remains a challenge. To enhance the safety and efficacy of existing coronary stents and to ultimately enhance long-term outcomes, the exploration and development of novel stent technologies become imperative. Currently, experimental swine models are considered the gold standard for testing stent performance. However, animal models have several limitations. Firstly, ethical concerns may arise due to the potential harm and suffering inflicted on the animals. Secondly, scientific limitations exist as animal models not always accurately represent human physiology and diseases. Lastly, animal experiments, especially those involving diseased animals, can be both costly and time-consuming. Based on these limitations, regulatory authorities such as ZonMW are promoting the development of alternative approaches, such as cell- and tissue-based human disease models. In cases where alternatives are not yet available or legislation still requires animal use, the MKMD program encourages maximizing the impact and quality of such experiments. In this process, reliable and human-mimicking animal models aid in the development of new animal-free models. In this spirit, the main objective of this work was two-fold: first, to maximize the results obtained from an existing diseased swine model, and second, to develop innovative alternatives for acute and chronic in vivo swine coronary stent models.
Original languageEnglish
Awarding Institution
  • Erasmus University Rotterdam
  • Duncker, Dirk-jan, Supervisor
  • van Esch, Jan H., Supervisor, External person
  • van Beusekom, H.M.M., Co-supervisor
  • van Steijn, Volkert, Co-supervisor, External person
Award date19 Jun 2024
Place of PublicationRotterdam
Print ISBNs978-94-6496-140-9
Publication statusPublished - 19 Jun 2024


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