The Protective Nature of a Fluoropolymer Stent

Fluoropolymer Safety Resulting from Fluoropassivation

Yet another factor sets XIENCE apart: the XIENCE fluoropolymer coating. Unlike other polymer coatings, the fluoropolymer interacts with proteins in the blood in a way that reduces thrombus formation—a process known as fluoropassivation.


Fluoropolymer Stent vs Bare Metal Stent and Biodegradable Polymer Stent

Moreover, XIENCE's fluoropolymer has minimal coating defects compared to biodegradable polymer drug-eluting stents (BP-DES).11 

In contrast to the visual above, most stents available today have non-fluorinated surfaces: biodegradable polymer stents, durable polymer stents or bare metal stents (BMS). These surfaces interact with proteins in the following ways:

  • The surfaces attract less albumin and more fibrinogen.3 
  • The fibrinogen, in turn, leads to more platelet adhesion and activation.12,13 
  • The platelets, fibrinogen and red blood cells can aggregate and create a thrombus.14,15 
Expert's Point of View: Fluoropolymers' Unique Interaction with Proteins

“As a class, fluoropolymers are unique in how they adsorb albumin and retain albumin. . . . Different polymers will adsorb albumin but also release it”

Kevin Healy, PhD

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“The thromboresistant properties of XIENCE do not depend fully on better re-endothelialization—since that affects less common late and very late ST. The difference in XIENCE’s rates of ST occurs as early as 30 days, when there is no endothelialization. So it’s the polymer which really has the thromboresistant properties.” 

— Tullio Palmerini, MD

Visual Evidence of Fluoropolymer Safety

In several analyses, XIENCE exhibits the most thromboresistance when compared to several different BP-DES.16,17 And this reduced inflammation can lead to improved healing.  

Least Thrombus Area with XIENCE vs BP-DES16

Expert's Point of View: Reduced Inflammatory Response

In the images “on the right you can see the [pro-thrombotic] platelet adherence. XIENCE [the image at the bottom] has hardly any attachments to it.”

Renu Virmani, MD, referring to the photomicrographs, where green indicates platelet adhesion

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† Bench test data shows that XIENCE Sierra performed better in crossability and was not statistically different in trackability and pushability compared to Resolute Onyx and SYNERGY stents. Bench test results may not necessarily be indicative of clinical performance. Test performed by and data on file at Abbott. Testing performed on XIENCE Sierra Everolimus Eluting Coronary Stent System (3.0 x 18 mm) n=5, SYNERGY Stent System (3.0 x 20 mm) n=5, Resolute Onyx Stent System (3.0 x 18 mm) n=5. Catheter performance crossability test measures average force to cross a challenging lesion model.

‡ Increased maximum expansion compared to other XIENCE Everolimus Eluting Coronary Stent System.

  1. Szott LM, et al. Biointerphases. 2016;11:029806. doi: 10.1116/1.4944586.
  2. Wertz CF, et al. Langmuir. 2001;17:3006-3016. doi: 10.1021/la0017781.
  3. Panchalingam V, et al. ASAIO J. 1993;39:M305-M309.
  4. Paton DM, et al. U.S. Patent 5,356,668.
  5. Garfinkle AM, et al. Trans Am Soc Artif Intern Organs. 1984;30:432-439.
  6. Fluorinated surfaces have been used for cardiovascular implants to benefit from thromboresistance and long-term biocompatibility.
  7. Ao PY, et al. Eur J Vasc Endovasc Surg. 2000;20:241-249.
  8. Lilenfeld R, et al. U.S. Patent 4,564,013.
  9. Chinn JA, et al. J Biomed Mater Res. 1998;39:130-140.
  10. Généreux P, et al. Circ Cardiovasc Interv. 2015;8:e001362. doi:10.1161/CIRCINTERVENTIONS.114.001362.
  11. In vivo coating and degradation study. Photos and data on file at Abbott Vascular. Max deployment in in-vitro degradation solution; vacuum dried for minimum of 5 hours.
  12. Wu Y, et al. J Biomed Mater Res. 2005. doi: 10.1002/jbm.a.30381.
  13. Tsai WB, et al. J Biomed Mater Res. 1999:44:130–139.
  14. Ratner BD, et al. Biomaterials Science, An Introduction to Materials in Medicine, 3rd ed. Elsevier Academic Press, San Diego, CA 2013, pp 551-552.
  15. Garfinkle AM, et al. Trans Am Soc Artif Intern Organs. 1984;30:432-439.
  16. Otsuka F, et al. JACC Cardiovasc Interv. 2015;8:1248-1260. doi: 10.1016/j.jcin.2015.03.029.
  17. Data for XIENCE vs Ultimaster on file with Abbott Vascular. 

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