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  • 1
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 95, No. 4 ( 1997-02-18), p. 1015-1021
    Abstract: Background Thrombosis is an important limitation of metallic coronary stents, especially in smaller vessels in which shear rates are high. Monoclonal antibody to platelet glycoprotein IIb/IIIa receptor (7E3) has been shown to inhibit shear-induced platelet aggregation. In this study, we compared the effects of 7E3, heparin, and aspirin on stent thrombosis in an ex vivo arteriovenous shunt model of high-shear blood flow. Methods and Results An ex vivo arteriovenous shunt was created in 10 anesthetized dogs. Control rough-surface slotted-tube nitinol stents (n=72) expanded to 2 mm in diameter in a tubular perfusion chamber were interposed in the shunt and exposed to flowing arterial blood at a shear rate of 2100 s −1 for 20 minutes. The animals were treated with intravenous murine 7E3 (Fab′) 2 (0.2, 0.4, and 0.8 mg/kg), heparin (100 U/kg), or aspirin (10 mg/kg). Effects of the test agents on thrombus weight, platelet aggregation, platelet P-selectin expression, bleeding time, and activated clotting time (ACT) were quantified. 7E3 reduced stent thrombosis by 95% (20±1 to 1±1 mg, P 〈 .001) and platelet aggregation by 94% (14±2 to 1±1 Ω, P 〈 .001) at the highest dose (0.8 mg/kg). 7E3 significantly prolonged bleeding time but had no effect on ACT and platelet P-selectin expression. Heparin prolonged ACT but had no significant effect on stent thrombosis or platelet aggregation. Aspirin, although it inhibited platelet aggregation by 65%, had no effect on stent thrombosis (19±2 versus 20±1 mg in controls). Conclusions 7E3 produced a dose-dependent inhibition of acute stent thrombosis under high-shear flow conditions. Stent thrombosis was resistant to heparin and aspirin. Thus, 7E3 may be an effective agent for preventing stent thrombosis.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1997
    detail.hit.zdb_id: 1466401-X
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  • 2
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 94, No. 9 ( 1996-11), p. 2228-2234
    Abstract: Background Coronary stenting is limited by subacute thrombosis, especially in smaller-diameter vessels, in which shear rates are high. The objective of the present study was to determine whether local delivery of a new type of NO donor, the NO adduct of N,N′ -dimethylhexanediamine (DMHD/NO), inhibits acute stent thrombosis (ST) at high-shear flow. Methods and Results Effects of local infusion of DMHD/NO, intravenous aspirin, and heparin on ST were evaluated in an ex vivo porcine AV shunt model. Nitinol stents (2 mm in diameter, n=120) were placed in a tubular chamber and perfused with blood from pigs (n=13) at a shear rate of 2100 s −1 for 20 minutes. ST was quantified by measurement of dry thrombus weight (TW). Effects on platelet aggregation (PA), blood pressure, bleeding time, and activated clotting time (ACT) were also examined. There was a dose-dependent inhibition of ST and PA by DMHD/NO. TW was reduced by 95% (1±2 versus 16±4 mg control, mean±SD, P 〈 .001), and PA was reduced by 75% (4±3 versus 14±9 Ω/min control, P 〈 .05) at the highest dose of 10 μmol/L. DMHD/NO had no effects on bleeding time, ACT, or blood pressure. In contrast, aspirin (10 mg/kg), despite inhibiting PA, had no effects on TW (12±5 versus 16±8 mg control, P =.3). Heparin (200 U/kg) reduced TW by 33% (14±4 versus 21±3 mg control, P 〈 .05) and prolonged ACT. Conclusions Local delivery of DMHD/NO produced a 15-fold inhibition of acute ST at high-shear flow without producing adverse systemic hemostatic or hemodynamic effects. Thus, treatment with DMHD/NO may be an effective strategy for prevention of stent thrombosis.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1996
    detail.hit.zdb_id: 1466401-X
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  • 3
    Online Resource
    Online Resource
    SAGE Publications ; 1996
    In:  Journal of Cardiovascular Pharmacology and Therapeutics Vol. 1, No. 2 ( 1996-04), p. 177-188
    In: Journal of Cardiovascular Pharmacology and Therapeutics, SAGE Publications, Vol. 1, No. 2 ( 1996-04), p. 177-188
    Abstract: Local drug therapy for preventing restenosis after angioplasty has been investigated for over a decade. Biologically active agents ranging from drugs to genes can be delivered locally using a wide variety of catheters. Microspheres, liposomes, and polymers have been used to enhance drug retention at the delivery site. More recently stents have been investigated as devices to attain local drug delivery, either by coating with polymers, seeding with genetically modified cells or by using them as a source of local radiation. Though the best method of delivering agents locally remains undefined, this approach is likely to emerge as an essential mode of therapy in the near future.
    Type of Medium: Online Resource
    ISSN: 1074-2484 , 1940-4034
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1996
    detail.hit.zdb_id: 2230155-0
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  • 4
    Online Resource
    Online Resource
    Elsevier BV ; 1997
    In:  Journal of the American College of Cardiology Vol. 30, No. 5 ( 1997-11), p. 1277-1283
    In: Journal of the American College of Cardiology, Elsevier BV, Vol. 30, No. 5 ( 1997-11), p. 1277-1283
    Type of Medium: Online Resource
    ISSN: 0735-1097
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 1997
    detail.hit.zdb_id: 1468327-1
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