Sustained Efficacy and Arterial Drug Retention by a Fast Drug Eluting Cross-Linked Fatty Acid Coronary Stent Coating
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Author(s)
Artzi, Natalie
Faucher, Keith M.
Moodie, Geoffrey
Albergo, Theresa
Conroy, Suzanne
Corbeil, Scott
Martakos, Paul
Virmani, Renu
Tzafriri, A Rami
Edelman, Elazer R
Date Issued
August 2015
Journal
Annals of Biomedical Engineering
Publisher
Springer US
Citation
Artzi, Natalie, Abraham R. Tzafriri, Keith M. Faucher, Geoffrey Moodie, Theresa Albergo, Suzanne Conroy, Scott Corbeil, Paul Martakos, Renu Virmani, and Elazer R. Edelman. “Sustained Efficacy and Arterial Drug Retention by a Fast Drug Eluting Cross-Linked Fatty Acid Coronary Stent Coating.” Ann Biomed Eng 44, no. 2 (August 28, 2015): 276–286.
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Author's final manuscript
Abstract
The long held assumption that sustained drug elution from stent coatings over weeks to months is imperative for clinical efficacy has limited the choice for stent coating materials. We developed and evaluated an omega-3 fatty acid (O3FA) based stent coating that is 85% absorbed and elutes 97% of its Sirolimus analog (Corolimus) load within 8d of implantation. O3FA coated stents sustained drug levels in porcine coronary arteries similarly to those achieved by slow-eluting durable coated Cypher Select Plus Stents and with significantly lower levels of granuloma formation and luminal stenosis. Computational modeling confirmed that diffusion and binding constants of Corolimus and Sirolimus are identical and explained that the sustained retention of Corolimus was facilitated by binding to high affinity intracellular receptors (FKBP12). First in man outcomes were positive—unlike Cypher stents where late lumen loss drops over 6 month, there was a stable effect without diminution in the presence of O3FA. These results speak to a new paradigm whereby the safety of drug eluting stents can be optimized through the use of resorbable biocompatible coating materials with resorption kinetics that coincide with the dissociation and tissue elimination of receptor-bound drug.
MIT Department
Massachusetts Institute of Technology. Institute for Medical Engineering & Science
Harvard University--MIT Division of Health Sciences and Technology
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DOI of Published Version
https://doi.org/10.1007/s10439-015-1435-z
