Direct comparison of coronary bare metal vs. drug-eluting stents: same platform, different mechanics?

Research output: Contribution to journalArticleResearch

Authors

  • Wolfram Schmidt
  • Peter Lanzer
  • Peter Behrens
  • Christoph Brandt-Wunderlich
  • Alper Öner
  • Hüseyin Ince
  • Klaus-Peter Schmitz
  • Niels Grabow

External Research Organisations

  • Martin Luther University Halle-Wittenberg
  • University of Rostock
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Details

Original languageEnglish
Article number2
Pages (from-to)2
JournalEuropean Journal of Medical Research
Volume23
Issue number1
Publication statusPublished - 8 Jan 2018
Externally publishedYes

Abstract

Background: Drug-eluting stents (DES) compared to bare metal stents (BMS) have shown superior clinical performance, but are considered less suitable in complex cases. Most studies do not distinguish between DES and BMS with respect to their mechanical performance. The objective was to obtain mechanical parameters for direct comparison of BMS and DES. Methods: In vitro bench tests evaluated crimped stent profiles, crossability in stenosis models, elastic recoil, bending stiffness (crimped and expanded), and scaffolding properties. The study included five pairs of BMS and DES each with the same stent platforms (all n = 5; PRO-Kinetic Energy, Orsiro: BIOTRONIK AG, Bülach, Switzerland; MULTI-LINK 8, XIENCE Xpedition: Abbott Vascular, Temecula, CA; REBEL Monorail, Promus PREMIER, Boston Scientific, Marlborough, MA; Integrity, Resolute Integrity, Medtronic, Minneapolis, MN; Kaname, Ultimaster: Terumo Corporation, Tokyo, Japan). Statistical analysis used pooled variance t tests for pairwise comparison of BMS with DES. Results: Crimped profiles in BMS groups ranged from 0.97 ± 0.01 mm (PRO-Kinetic Energy) to 1.13 ± 0.01 mm (Kaname) and in DES groups from 1.02 ± 0.01 mm (Orsiro) to 1.13 ± 0.01 mm (Ultimaster). Crossability was best for low profile stent systems. Elastic recoil ranged from 4.07 ± 0.22% (Orsiro) to 5.87 ± 0.54% (REBEL Monorail) including both BMS and DES. The bending stiffness of crimped and expanded stents showed no systematic differences between BMS and DES neither did the scaffolding. Conclusions: Based on in vitro measurements BMS appear superior to DES in some aspects of mechanical performance, yet the differences are small and not class uniform. The data provide assistance in selecting the optimal system for treatment and assessment of new generations of bioresorbable scaffolds.

Keywords

    Drug-Eluting Stents/adverse effects, Mechanical Phenomena, Self Expandable Metallic Stents/adverse effects, Bare metal stents, Biomechanics, Interventional cardiology, Drug-eluting stents

ASJC Scopus subject areas

Cite this

Direct comparison of coronary bare metal vs. drug-eluting stents: same platform, different mechanics? / Schmidt, Wolfram; Lanzer, Peter; Behrens, Peter et al.
In: European Journal of Medical Research, Vol. 23, No. 1, 2, 08.01.2018, p. 2.

Research output: Contribution to journalArticleResearch

Schmidt, W, Lanzer, P, Behrens, P, Brandt-Wunderlich, C, Öner, A, Ince, H, Schmitz, K-P & Grabow, N 2018, 'Direct comparison of coronary bare metal vs. drug-eluting stents: same platform, different mechanics?', European Journal of Medical Research, vol. 23, no. 1, 2, pp. 2. https://doi.org/10.1186/s40001-017-0300-y
Schmidt, W., Lanzer, P., Behrens, P., Brandt-Wunderlich, C., Öner, A., Ince, H., Schmitz, K.-P., & Grabow, N. (2018). Direct comparison of coronary bare metal vs. drug-eluting stents: same platform, different mechanics? European Journal of Medical Research, 23(1), 2. Article 2. https://doi.org/10.1186/s40001-017-0300-y
Schmidt W, Lanzer P, Behrens P, Brandt-Wunderlich C, Öner A, Ince H et al. Direct comparison of coronary bare metal vs. drug-eluting stents: same platform, different mechanics? European Journal of Medical Research. 2018 Jan 8;23(1):2. 2. doi: 10.1186/s40001-017-0300-y
Schmidt, Wolfram ; Lanzer, Peter ; Behrens, Peter et al. / Direct comparison of coronary bare metal vs. drug-eluting stents : same platform, different mechanics?. In: European Journal of Medical Research. 2018 ; Vol. 23, No. 1. pp. 2.
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title = "Direct comparison of coronary bare metal vs. drug-eluting stents: same platform, different mechanics?",
abstract = "Background: Drug-eluting stents (DES) compared to bare metal stents (BMS) have shown superior clinical performance, but are considered less suitable in complex cases. Most studies do not distinguish between DES and BMS with respect to their mechanical performance. The objective was to obtain mechanical parameters for direct comparison of BMS and DES. Methods: In vitro bench tests evaluated crimped stent profiles, crossability in stenosis models, elastic recoil, bending stiffness (crimped and expanded), and scaffolding properties. The study included five pairs of BMS and DES each with the same stent platforms (all n = 5; PRO-Kinetic Energy, Orsiro: BIOTRONIK AG, B{\"u}lach, Switzerland; MULTI-LINK 8, XIENCE Xpedition: Abbott Vascular, Temecula, CA; REBEL Monorail, Promus PREMIER, Boston Scientific, Marlborough, MA; Integrity, Resolute Integrity, Medtronic, Minneapolis, MN; Kaname, Ultimaster: Terumo Corporation, Tokyo, Japan). Statistical analysis used pooled variance t tests for pairwise comparison of BMS with DES. Results: Crimped profiles in BMS groups ranged from 0.97 ± 0.01 mm (PRO-Kinetic Energy) to 1.13 ± 0.01 mm (Kaname) and in DES groups from 1.02 ± 0.01 mm (Orsiro) to 1.13 ± 0.01 mm (Ultimaster). Crossability was best for low profile stent systems. Elastic recoil ranged from 4.07 ± 0.22% (Orsiro) to 5.87 ± 0.54% (REBEL Monorail) including both BMS and DES. The bending stiffness of crimped and expanded stents showed no systematic differences between BMS and DES neither did the scaffolding. Conclusions: Based on in vitro measurements BMS appear superior to DES in some aspects of mechanical performance, yet the differences are small and not class uniform. The data provide assistance in selecting the optimal system for treatment and assessment of new generations of bioresorbable scaffolds.",
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Download

TY - JOUR

T1 - Direct comparison of coronary bare metal vs. drug-eluting stents

T2 - same platform, different mechanics?

AU - Schmidt, Wolfram

AU - Lanzer, Peter

AU - Behrens, Peter

AU - Brandt-Wunderlich, Christoph

AU - Öner, Alper

AU - Ince, Hüseyin

AU - Schmitz, Klaus-Peter

AU - Grabow, Niels

N1 - Funding information: Financial support by the Federal Ministry of Education and Research (BMBF) within RESPONSE. “Partnership for Innovation in Implant Technology”is grate? fully acknowledged.

PY - 2018/1/8

Y1 - 2018/1/8

N2 - Background: Drug-eluting stents (DES) compared to bare metal stents (BMS) have shown superior clinical performance, but are considered less suitable in complex cases. Most studies do not distinguish between DES and BMS with respect to their mechanical performance. The objective was to obtain mechanical parameters for direct comparison of BMS and DES. Methods: In vitro bench tests evaluated crimped stent profiles, crossability in stenosis models, elastic recoil, bending stiffness (crimped and expanded), and scaffolding properties. The study included five pairs of BMS and DES each with the same stent platforms (all n = 5; PRO-Kinetic Energy, Orsiro: BIOTRONIK AG, Bülach, Switzerland; MULTI-LINK 8, XIENCE Xpedition: Abbott Vascular, Temecula, CA; REBEL Monorail, Promus PREMIER, Boston Scientific, Marlborough, MA; Integrity, Resolute Integrity, Medtronic, Minneapolis, MN; Kaname, Ultimaster: Terumo Corporation, Tokyo, Japan). Statistical analysis used pooled variance t tests for pairwise comparison of BMS with DES. Results: Crimped profiles in BMS groups ranged from 0.97 ± 0.01 mm (PRO-Kinetic Energy) to 1.13 ± 0.01 mm (Kaname) and in DES groups from 1.02 ± 0.01 mm (Orsiro) to 1.13 ± 0.01 mm (Ultimaster). Crossability was best for low profile stent systems. Elastic recoil ranged from 4.07 ± 0.22% (Orsiro) to 5.87 ± 0.54% (REBEL Monorail) including both BMS and DES. The bending stiffness of crimped and expanded stents showed no systematic differences between BMS and DES neither did the scaffolding. Conclusions: Based on in vitro measurements BMS appear superior to DES in some aspects of mechanical performance, yet the differences are small and not class uniform. The data provide assistance in selecting the optimal system for treatment and assessment of new generations of bioresorbable scaffolds.

AB - Background: Drug-eluting stents (DES) compared to bare metal stents (BMS) have shown superior clinical performance, but are considered less suitable in complex cases. Most studies do not distinguish between DES and BMS with respect to their mechanical performance. The objective was to obtain mechanical parameters for direct comparison of BMS and DES. Methods: In vitro bench tests evaluated crimped stent profiles, crossability in stenosis models, elastic recoil, bending stiffness (crimped and expanded), and scaffolding properties. The study included five pairs of BMS and DES each with the same stent platforms (all n = 5; PRO-Kinetic Energy, Orsiro: BIOTRONIK AG, Bülach, Switzerland; MULTI-LINK 8, XIENCE Xpedition: Abbott Vascular, Temecula, CA; REBEL Monorail, Promus PREMIER, Boston Scientific, Marlborough, MA; Integrity, Resolute Integrity, Medtronic, Minneapolis, MN; Kaname, Ultimaster: Terumo Corporation, Tokyo, Japan). Statistical analysis used pooled variance t tests for pairwise comparison of BMS with DES. Results: Crimped profiles in BMS groups ranged from 0.97 ± 0.01 mm (PRO-Kinetic Energy) to 1.13 ± 0.01 mm (Kaname) and in DES groups from 1.02 ± 0.01 mm (Orsiro) to 1.13 ± 0.01 mm (Ultimaster). Crossability was best for low profile stent systems. Elastic recoil ranged from 4.07 ± 0.22% (Orsiro) to 5.87 ± 0.54% (REBEL Monorail) including both BMS and DES. The bending stiffness of crimped and expanded stents showed no systematic differences between BMS and DES neither did the scaffolding. Conclusions: Based on in vitro measurements BMS appear superior to DES in some aspects of mechanical performance, yet the differences are small and not class uniform. The data provide assistance in selecting the optimal system for treatment and assessment of new generations of bioresorbable scaffolds.

KW - Drug-Eluting Stents/adverse effects

KW - Mechanical Phenomena

KW - Self Expandable Metallic Stents/adverse effects

KW - Bare metal stents

KW - Biomechanics

KW - Interventional cardiology

KW - Drug-eluting stents

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