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(Circulation. 1997;95:1549-1553.)
© 1997 American Heart Association, Inc.

Articles

Experimental Study of Thrombogenicity and Foreign Body Reaction Induced by Heparin-Coated Coronary Stents

Ivan De Scheerder, MD, PhD; Kai Wang, MD; Krzysztof Wilczek, MD; Dirk Meuleman, PhD; Ronald Van Amsterdam, PhD; Gerard Vogel, BS; Jan Piessens, MD, PhD; Frans Van de Werf, MD, PhD

From the Department of Cardiology (I.D.S., K. Wang, K. Wilczek, J.P., F.V.D.W.), Gasthuisberg, University Hospital, Leuven, Belgium; and Department of Vascular Pharmacology (D.M., R.V.A., G.V.), Organon International BV, Oss, The Netherlands.

Correspondence to I. De Scheerder, MD, PhD, Gasthuisberg University Hospital, Department of Cardiology, Herestraat 49, 3000 Leuven, Belgium.

Background Results of recent randomized clinical trials have revealed a significant reduction in angiographic restenosis rate when adjunctive stenting was performed after conventional coronary balloon angioplasty. The thrombogenicity of metal stents, however, remains a concern. In the present study, we compare the thrombogenicity of heparin-coated coronary stents with that of bare metallic coronary stents.

Methods and Results Thrombogenicity of metallic coronary stents (four heparin-coated and eight bare stents) was studied in a rat arteriovenous shunt model with the use of ¹²⁵I-labeled fibrinogen and ⁵¹Cr-labeled platelets. Total clot weight after 30-minute follow-up was significantly lower in the heparin-coated stents compared with the bare stents (8.1±3.7 versus 25.8±4.6 mg; P<.001). Relative ¹²⁵I and ⁵¹Cr activities in the stents were significantly higher in the bare stents than in the heparin-coated stents (¹²⁵I, 1.03±0.43 versus 0.18±0.04, P=.003; ⁵¹Cr, 17.5±6.8 versus 4.4±1.0, P=.004). Subsequently, heparin-coated and bare stents were randomly implanted in the right coronary artery of 20 domestic pigs. Angiographic parameters were similar between both groups at baseline and after 6-week follow-up. Morphometry also did not show a significant difference in lumen area (bare, 1.03±0.83 mm²; heparin-coated, 1.12±0.73 mm²; P=NS) or neointimal hyperplasia (bare, 1.01±0.81 mm²; heparin-coated, 1.21±0.57 mm²; P=NS).

Conclusions Heparin coating of metallic coronary stents decreases their thrombogenicity but does not improve late vessel patency and neointimal hyperplasia at follow-up in a porcine coronary model.

Key Words: stents • heparin • thrombus • stenosis

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