Seung‑Woon Baek1,2,3†, Da‑Seul Kim1,4†, Duck Hyun Song1†, Han Byul Kim5, Semi Lee1, Jun Hyuk Kim1, Jun‑Kyu Lee1, Young Joon Hong6, Chun Gwon Park2,3 and Dong Keun Han1*
1Department of Biomedical Science, CHA University, 335 Pangyo‑Ro, Bundang‑Gu, Seongnam‑Si, Gyeonggi 13488, Korea.
2Department of Biomedical Engineering, SKKU Institute for Convergence, Sungkyunkwan University (SKKU), 2066 Seobu‑ro, Jangan‑gu, Suwon‑si, Gyeonggi 16419, Korea.
3Department of Intelligent Precision Healthcare Convergence, SKKU Institute for Convergence, Sungkyunkwan University, 2066 Seobu‑ro, Jangan‑gu, Suwon‑si, Gyeonggi
4School of Integrative Engineering, Chung-Ang University, 84 Heukseok‑ro, Dongjak‑gu, Seoul 06974, Korea.
5The Cardiovascular Convergence Research Center of Chonnam, National University Hospital Designated By Korea Ministry of Health and Welfare, 42 Jebong‑ro, Dong‑gu, Gwangju 61469, Korea.
6Division of Cardiology of Chonnam, Cardiovascular Convergence Research Center Nominated By Korea Ministry of Health and Welfare, National University Hospital, 42 Jebong‑ro, Dong‑gu, Gwangju 61469, Korea.
†Seung-Woon Baek, Da-Seul Kim and Duck Hyun Song contributed equally to this work.
*Correspondence: Dong Keun Han
Background: Coronary artery disease is a cardiovascular disease with a high mortality and mortality rate in modern society. Vascular stent insertion to restore blood flow is essential to treat this disease. A fully biodegradable vascular scaffold (BVS) is a vascular poly (L-lactic acid) (PLLA) stent that is receiving growing interest as this is biodegradable in the body and does not require secondary removal surgery. However, acidic byproducts composed of PLLA produced during the biodegradation of the BVS can induce an inflammatory response. Magnesium hydroxide, a basic inorganic particle, neutralizes the acidic byproducts of PLLA. METHODS: In this study, we investigated using a BVS coated with everolimus and surface-modified magnesium hydroxide that suppresses smooth muscle cell proliferation and protects endothelial cells, respectively. The various characteristics of the functional stent were evaluated using in vitro and in vivo analyses. RESULTS: The BVS was successfully prepared with evenly coated everolimus and surface-modified magnesium hydroxide. A neutral pH value was maintained by magnesium hydroxide during degradation, and everolimus was released for one month. The coated BVS effectively inhibited protein adsorption and platelet adhesion, demonstrating excellent blood compatibility. In vitro analysis showed that BVS protects endothelial cells with magnesium hydroxide and selectively inhibits smooth muscle cell proliferation via everolimus treatment. The functional BVS was inserted into porcine coronary arteries for 28 days, and the results demonstrated that the restenosis and inflammation greatly decreased and re-endothelialization was enhanced as compared to others.
Conclusions: This study provides new insights into the design of drug-incorporated BVS stent for coronary artery disease.