Endothelial Barrier Protein Expression in Biodegradable Polymer Sirolimus-Eluting Versus Durable Polymer Everolimus-Eluting Metallic Stents

Hiroyoshi Mori, Qi Cheng, Christoph Lutter, Samantha Smith, Liang Guo, Matthew Kutyna, Sho Torii, Emanuel Harari, Eduardo Acampado, Michael Joner, Frank D. Kolodgie, Renu Virmani, Aloke V. Finn

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Objectives This study sought to investigate endothelial coverage and barrier protein expression following stent implantation. Background Biodegradable polymer drug-eluting stents (BP-DES) have been purported to have biological advantages in vessel healing versus durable polymer DES (DP-DES), although clinical trial data suggest equipoise. Methods Biodegradable polymer-sirolimus-eluting stents (BP-SES), durable polymer-everolimus-eluting stents (DP-EES), and bare-metal stents (BMS) were compared. In the rabbit model (28, 45, and 120 days), stented arteries underwent light microscopic analysis and immunostaining for the presence of vascular endothelium (VE)-cadherin, an endothelial barrier protein, and were subjected to confocal microscopy and scanning electron microscopy. A cell culture study in stented silicone tubes was performed to assess cell proliferation. Results Light microscopic assessments were similar between BP-SES and DP-EES. BMS showed nearly complete expression of VE-cadherin at 28 days, whereas both DES showed significantly less with results favoring BP-SES versus DP-EES (39% coverage in BP-SES, 22% in DP-EES, 95% in BMS). Endothelial cell morphologic patterns differed according to stent type with BMS showing a spindle-like shape, DP-EES a cobblestone pattern, and BP-SES a shape in between. VE-cadherin-negative areas showed greater surface monocytes regardless of type of stent. Cell proliferation was suppressed in both DES with numerically less suppression in BP-SES versus DP-EES. Conclusions This is the first study to examine VE-cadherin expression after DES. All DES demonstrated deficient barrier expression relative to BMS with results favoring BP-SES versus DP-EES. These findings may have important implications for the development of neoatherosclerosis in different stent types.

Original languageEnglish
Pages (from-to)2375-2387
Number of pages13
JournalJACC: Cardiovascular Interventions
Issue number23
StatePublished - 11 Dec 2017
Externally publishedYes


  • VE-cadherin
  • biodegradable polymer
  • drug-eluting stent(s)
  • durable polymer
  • endothelium


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