Plaque burden is associated with minimal intimal coverage following drug-eluting stent implantation in an adult familial hypercholesterolemia swine model

Francesca Razzi, Jouke Dijkstra, Ayla Hoogendoorn, Karen Witberg, Jurgen Ligthart, Dirk J. Duncker, Jan van Esch, Jolanda J. Wentzel, Volkert van Steijn, Gijs van Soest, Evelyn Regar, Heleen M.M. van Beusekom*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
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Abstract

Safety and efficacy of coronary drug-eluting stents (DES) are often preclinically tested using healthy or minimally diseased swine. These generally show significant fibrotic neointima at follow-up, while in patients, incomplete healing is often observed. The aim of this study was to investigate neointima responses to DES in swine with significant coronary atherosclerosis. Adult familial hypercholesterolemic swine (n = 6) received a high fat diet to develop atherosclerosis. Serial OCT was performed before, directly after, and 28 days after DES implantation (n = 14 stents). Lumen, stent and plaque area, uncovered struts, neointima thickness and neointima type were analyzed for each frame and averaged per stent. Histology was performed to show differences in coronary atherosclerosis. A range of plaque size and severity was found, from healthy segments to lipid-rich plaques. Accordingly, neointima responses ranged from uncovered struts, to minimal neointima, to fibrotic neointima. Lower plaque burden resulted in a fibrotic neointima at follow-up, reminiscent of minimally diseased swine coronary models. In contrast, higher plaque burden resulted in minimal neointima and more uncovered struts at follow-up, similarly to patients’ responses. The presence of lipid-rich plaques resulted in more uncovered struts, which underscores the importance of advanced disease when performing safety and efficacy testing of DES.

Original languageEnglish
Article number10683
Number of pages10
JournalScientific Reports
Volume13
Issue number1
DOIs
Publication statusE-pub ahead of print - 1 Jul 2023

Bibliographical note

Funding Information:
Authors Dr. Volkert van Steijn and Dr. Gijs van Soest contributed equally to this work. Maaike te Lintel Hekkert and Mathijs Stam are thanked for their assistance in performing the experiments.

Publisher Copyright:
© 2023, The Author(s).

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