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    Oral Communication

    Coagulation and Natural Anticoagulants

    Novel Antithrombotic Strategies

    OC 62.3 - A noble metal stent coating reduces thrombo-inflammatory reactions and acute stent thrombosis – an in vitro and in vivo study

    Tuesday, June 27, 2023
    15:15 – 15:30 ET
    Room: 710B
    Session Available As: On-Demand

      Presenting Author(s)

    • Mikael Sandell, MSc (he/him/his)

      PhD Student
      KTH Royal Institute of Technology
      Stockholm, Stockholms Lan, Sweden

      • Co-Author(s)

    • AE

      Anna Ericsson

      Laboratory Scientist
      Bactiguard AB
      Stockholm, Stockholms Lan, Sweden

    • JA

      Jonathan Al-Saadi

      PhD Student
      Karolinska Institute
      Stockholm, Stockholms Lan, Sweden

    • BS

      Billy Södervall

      Senior Technical Advisor
      Bactiguard AB
      Stockholm, Stockholms Lan, Sweden

    • ES

      Erika Södergren

      Laboratory Manager
      Bactiguard AB
      Stockholm, Stockholms Lan, Sweden

    • SG

      Stefan Grass

      Chief Medical Officer
      Bactiguard AB
      Stockholm, Stockholms Lan, Sweden

    • JS

      Javier Sanchez

      Blood Compatibility Specialist
      Bactiguard AB
      Stockholm, Stockholms Lan, Sweden

    • SH

      Staffan Holmin

      Professor
      Karolinska Institute
      Stockholm, Stockholms Lan, Sweden

    Background: Inherent to any stenting procedure is the need of dual antiplatelet therapy (DAPT) to prevent stent thrombosis. Clinical guidelines recommend DAPT treatment in the acute phase and then 6 – 12 months after the procedure, depending on stent type and patient factors. This treatment, while preventing acute and long-term complications, poses an increased risk of bleeding in the short and longer term. For patients requiring additional surgical interventions, this is especially troublesome.

    Aims: Testing a novel nanostructured noble metal coating on stents that has the potential to reduce protein deposition and platelet activation. This coating could lead to a reduction in the DAPT dose in the acute phase, due to a reduced load on the thrombo-inflammatory reaction.

    Methods: Twelve pigs underwent implantation of coated and non-coated stents for paired comparisons in a blinded study design. The experiment was terminated after two hours, representing the acute phase of implantation. The stents were implanted in the lingual artery on contralateral sides. Volumetric analysis of CT-angio data was performed by a treatment blinded assessor. In vitro measurements of several biomarkers in a chandler loop model were performed on human and porcine blood in parallel with the in vivo trials on tubes of the same material with a corresponding paired setup. Informed consent was obtained from all human participants.

    Results: The volumetric data demonstrate a significant thrombus reduction in the coated stent group compared to the control. This effect was seen already one hour after implantation and was further accentuated after two hours. The in vitro data showed a significant reduction of coagulation activation in the coated group compared to the control, in both human and porcine blood.

    Conclusion(s): This coating shows promise as an implant material addition and could potentially decrease the DAPT dose in the acute clinical setting due to a reduced foreign body response.

    Learning Objectives:

    • Upon completion, participants will be able to understand how noble metal surface coatings can potentially exhibit compatibility with blood in stent implantation.
    • Upon completion, participants will be able to perform parallell in vivo and in vitro porcine models, as illustrated in our presentation.
    • Upon completion, participants will be able to examine angiography data in terms of flow disruptions and thrombus formation in stent trials.