Accelerating endothelialization of coronary stents by capturing circulating endothelial progenitor cells

Drug-eluting stents (DES) have become the standard of care for the treatment of coronary artery disease. However, late stent thrombosis has emerged as a major concern, especially in ‘off-label’ use. Pathologic studies of patients dying from late DES thrombosis demonstrate delayed arterial healing, characterized by persistent fibrin deposition and poor endothelialization. In recent years, a novel prohealing device was developed that captures circulating endothelial progenitor cells (EPCs) by immobilized antihuman-CD34 antibody as a surface coating. EPCs have the ability to migrate to areas of vascular injury and aid in the regeneration of damaged and dysfunctional endothelium. Preclinical results of the EPC-capture stent have shown promise in accelerating endothelialization as compared with bare metal and DES. Clinically, the safety and efficacy of the EPC-capture stent has been proven in numerous clinical trials with low incidence of late stent thrombosis. In this article, we discuss the relevance of the EPC-capture technology and the significance of current preclinical and clinical studies.