Introduction New coated flow-diverters (FDs) claim for antithrombotic properties and increased arterial wall integration.

Aim of Study This study aims to compare in vivo endothelial coverage of coated and uncoated FD in the setting of different antiplatelet regiments.

Methods In rabbit aortas, 3 different FDs (Silk Vista – SV; Pipeline with Shield technology – PED shield; Surpass Evolve – SE) were implanted in each animal with 3 different antiplatelet regimens: no antiplatelet therapy, aspirin alone, or aspirin and ticagrelor. Four weeks after FD implantations, angiography, flat-panel CT and Optical Coherence Tomography (OCT) were performed before harvest of the aorta. Extensive histopathology analyzes were performed including Environmental Scanning Electron Microscopy (ESEM), Multiphoton Microscopy (MPM) and histological staining with qualitative and/or quantitative assessment of device coverage.

Results All 23 included FDs remained patent without hyperplasia. Qualitative stent coverage assessment revealed that there were no statically significant differences between all FD groups (p=0.19, p=0.45, p=0.40, and p=0.84 for OCT, ESEM, MPM and histology, respectively). Quantitative neointimal measurement histopathologic sections also showed similar results between all 3 FD groups (p=0.70); but was significantly different between the 3 groups of antiplatelet regimens (p=0.07) with higher rate in the no antiplatelet group (p=0.05 versus aspirin alone and p=0.03 versus aspirin and ticagrelor).

Conclusion Our study provides evidence that FD integration into the arterial wall is similar between coated (PED shield) and uncoated devices (SV, SE) despite the use of coated surfaces, whichever the antiplatelet regiment. There is a need to promote FD integration with specific surface coverage.

Disclosure of Interest Nothing to disclose.