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Erschienen in: Basic Research in Cardiology 4/2011

01.07.2011 | Original Contribution

Acute vasomotor paralysis and potential downstream effects of paclitaxel from stents implanted for saphenous vein aorto-coronary bypass stenosis

verfasst von: Petra Kleinbongard, Dirk Böse, Thomas Konorza, Florian Steinhilber, Stefan Möhlenkamp, Holger Eggebrecht, Theodor Baars, Hubertus Degen, Michael Haude, Bodo Levkau, Raimund Erbel, Gerd Heusch

Erschienen in: Basic Research in Cardiology | Ausgabe 4/2011

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Abstract

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 μmol/l with BMS and 2.0 ± 0.4 μmol/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 BMS-aspirate plasma attenuated vasoconstriction. PES-aspirate induced microtubular condensation in immunofluorescence microscopy. Results indicate that aspirate from PES implantation attenuates vasoconstriction, possibly secondary to microtubular stabilization. Such acute downstream vascular paralysis could be beneficial in preventing a no-reflow phenomenon in patients undergoing stenting.
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Metadaten
Titel
Acute vasomotor paralysis and potential downstream effects of paclitaxel from stents implanted for saphenous vein aorto-coronary bypass stenosis
verfasst von
Petra Kleinbongard
Dirk Böse
Thomas Konorza
Florian Steinhilber
Stefan Möhlenkamp
Holger Eggebrecht
Theodor Baars
Hubertus Degen
Michael Haude
Bodo Levkau
Raimund Erbel
Gerd Heusch
Publikationsdatum
01.07.2011
Verlag
Springer-Verlag
Erschienen in
Basic Research in Cardiology / Ausgabe 4/2011
Print ISSN: 0300-8428
Elektronische ISSN: 1435-1803
DOI
https://doi.org/10.1007/s00395-011-0177-9

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