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Thromboresistance and Functional Healing in the COBRA PzF Stent versus Competitor DES: Implications for Dual Anti-Platelet Therapy.

AIMS
To investigate the COBRA-PzF stent (C-PzF) with respect to thrombogenicity and healing versus conventional drug-eluting stents (DES) in dedicated preclinical models to evaluate their suitability for short-term dual anti-platelet therapy (DAPT).


METHODS AND RESULTS
To examine acute thrombogenicity, C-PzF, durable polymer drug-eluting stent (DP-DES), and bioabsorable polymer DES (BP-DES) were compared in a porcine arteriovenous shunt model and in a rabbit model to evaluate endothelial coverage at 14 days. Barrier function at 28 days in the rabbit was assessed in the former stents as well as in polymer free DES (PF-BES). Number of clots by scanning electron microscope (SEM) was significantly less in C-PzF and DP-EES versus BP-EES. Endothelial coverage at 14 days was significantly greater in C-PzF versus DP-EES and BP-EES by CD31/PECAM-1 positive area in confocal microscopy (CM) (24.7% vs. 11.9% vs. 3.7%, respectively) and scanning electron microscope (SEM) (99.0% vs. 29.6% vs. 17.7%, respectively). Barrier protein expression by confocal microscopy for p120/vascular endothelial-cadherin complex was significantly greater in C-PzF versus DP-EES, BP-EES, and PF-BES (82.6% vs. 12.8% vs. 14.4% vs. 18.1%, respectively). Percentage of Evan's Blue positive area was the least in C-PzF versus all groups (22.0% vs.70.7% vs. 66.4% vs. 55.2%, respectively).


CONCLUSIONS
C-PzF demonstrated a unique combination of thrombogenicity and healing advantages compared to contemporary DES and may be uniquely suitable for very short-term DAPT.