Acute vasomotor paralysis and potential downstream effects of paclitaxel from stents implanted for saphenous vein aorto-coronary bypass stenosis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Petra Kleinbongard Dirk Bo¨se Thomas Konorza Florian Steinhilber Stefan Mo¨hlenkamp Holger Eggebrecht Theodor Baars Hubertus Degen Mic
- چاپ و سال / کشور: 2011
Description
Implantation of bare metal stents (BMS) induces the release not only of particulate debris, but also of soluble vasoconstrictors which contribute to microvascular impairment. So this study aimed at addressing the potential attenuation of such vasoconstriction using paclitaxel eluting stents (PES). Using a distal protection/aspiration device, coronary arterial blood was retrieved before and during stent [n = 14 BMS, n = 14 PES, n = 3 sirolimus eluting stents (SES)] implantation in patients with saphenous vein aorto-coronary bypass stenosis and analyzed for plasma serotonin and thromboxane B2 concentrations. The vasoconstriction of rat mesenteric arteries with intact (?E) and denuded (-E) endothelium in response to coronary arterial or aspirate plasma was quantified and normalized to that by potassium chloride (KClmax = 100%). Coronary arterial plasma before stent implantation induced a vasoconstriction of 30–43%, which was independent of endothelial integrity. Serotonin-release was 2.2 ± 0.5 lmol/l with BMS and 2.0 ± 0.4 lmol/l with PES, thromboxane B2-release was 26 ± 5 pg/ml with BMS and 22 ± 8 pg/ml with PES. BMS- and SES-aspirate plasma induced a vasoconstriction of 68 ± 18% (?E)/93 ± 14% (-E) and 81 ± 17% (?E)/ 124 ± 14% (-E), respectively. In contrast, PES-aspirate plasma induced only minor vasoconstriction of 8 ± 3% (?E)/12 ± 5% (-E). Addition of paclitaxel to BMSaspirate plasma attenuated vasoconstriction. PES-aspirate induced microtubular condensation in immunofluorescence microscopy. Results indicate that aspirate from PES implantation attenuates vasoconstriction, possibly secondaryM to microtubular stabilization. Such acute downstream vascular paralysis could be beneficial in preventing a no-reflow phenomenon in patients undergoing stenting
Basic Res Cardiol (2011) 106:681–689 Received: 9 March 2011 / Accepted: 29 March 2011 / Published online: 7 April 2011
