Prevention of in-stent restenosis with endothelial progenitor cell (EPC) capture stent placement combined with regional EPC transplantation: An atherosclerotic rabbit model.
BACKGROUND
Even with drug-eluting stents, the risk of in-stent restenosis (ISR) remains high. The goal of this study was to investigate the use of an endothelial progenitor cell (EPC) capture stent plus regional EPC transplantation to reduce the ISR rate.


METHODS
Endothelial progenitor cell capture stents were fabricated using fibrin gel and anti-CD34 plus anti-VEGFR-2 dual antibodies. Twenty male New Zealand white rabbits established as an atherosclerotic model were randomly divided into two groups: group 1 (n = 10), in which EPC capture stents were deployed into the right iliac artery; and group 2 (n = 10), in which sirolimus-eluting stents were placed. In both groups, EPCs were transplanted into target vessels beyond the stents, with outflow blocked. Radiologic-pathologic correlation outcomes were reviewed after 2 months.


RESULTS
The technical success rate of EPC capture stent placement plus EPC transplantation was 100%. The ISR rate in group 1 was lower than in group 2 (1/10 vs. 4/10; p > 0.05). Minimal luminal diameters were larger in group 1 than in group 2 (computed tomographic angiography, 1.85 ± 0.15 mm vs. 1.50 ± 0.20 mm; duplex ultrasound, 1.90 ± 0.10 mm vs. 1.70 ± 0.30 mm; p > 0.05). Transplanted EPCs were tracked positively only in group 1. Pathologic analysis demonstrated neointimal hyperplasia thickness of 0.21 ± 0.09 mm in group 1 vs. 0.11 ± 0.07 mm in group 2 (p < 0.05).


CONCLUSION
Endothelial progenitor cell capture stent placement plus local EPC transplant decreases the ISR rate through thrombosis reduction rather than through neointimal hyperplasia inhibition.
['Huang|You-Hua|YH|', 'Xu|Qiang|Q|', 'Shen|Tao|T|', 'Li|Jian-Ke|JK|', 'Sheng|Jing-Yu|JY|', 'Shi|Hong-Jian|HJ|']
D000800:Angioplasty, Balloon D000818:Animals D000906:Antibodies D018952:Antigens, CD34 D050197:Atherosclerosis D002478:Cells, Cultured D020099:Coated Materials, Biocompatible D004195:Disease Models, Animal D066026:Endothelial Progenitor Cells D005353:Fibronectins D007083:Iliac Artery D008297:Male D058226:Plaque, Atherosclerotic D011474:Prosthesis Design D011817:Rabbits D012008:Recurrence D015607:Stents D040301:Vascular Endothelial Growth Factor Receptor-2
in-stent restenosis endothelial progenitor cells transplantation drug-eluting stent thrombosis