Comparison of Diamond-Like, Carbon-Coated, Nitinol Stents With or Without Polyethylene Glycol Grafting and Uncoated Nitinol Stents in a Canine Iliac Artery Modelniostopic Rearrangement of the Substrate Atoms during Ar Bombardment on Pd (001) Surface

Jin Hyoung Kim, Ji Hoon Shin, Dong Ho Shin, Myoung-Woon Moon, Kwideok Park, Tae-Hyung Kim, Kyoung Min Shin, Yong Hyun Won, Dong Keun Han, Kwang-Ryeol Lee
 

Neointimal hyperplasia is a major complication of endovascular stent placement with consequent in-stent restenosis or occlusion. The improvement of biocompatibility of the stent designs may reduce stent-associated thrombosis and in-stent restenosis. We hypothesized that the use of a diamond-like, carbon (DLC)-coated, nitinol stent or a Polyethylene Glycol (PEG)-DLC-coated nitinol stent can reduce the formation of neointimal hyperplasia, thereby improving stent patency with improved biocompatibility. A total of 24 stents were implanted, under general anesthesia, into the iliac arteries of six dogs (four stents in each dog) using the carotid artery approach. The experimental study dogs were divided into three groups, i.e. the uncoated nitinol stent group (n = 8), the DLC-nitinol stent group (n = 8), and the PEG-DLC-nitinol stent group (n = 8). The mean percentage of neointimal hyperplasia was significantly less in the DLC-nitinol stent group (26.7 ± 7.6%) than in the nitinol stent group (40.0 ± 20.3%) (p = 0.021). However, the mean percentage of neointimal hyperplasia was significantly greater in the PEG-DLC-nitinol (58.7 ± 24.7%) stent group than in the nitinol stent group (40.0 ± 20.3%) (p = 0.01). Our findings indicate that DLC-coated nitinol stents may induce less neointimal hyperplasia than conventional nitinol stents following implantation in a canine iliac artery model. However, the DLC-coated, nitinol stent surface when reformed with PEG, induces more neointimal hyperplasia than either conventional nitinol or a DLC-coated nitinol stent.