# Equivalence and endothelial safety of temporary intracoronary shunt device: Insights from preclinical porcine and rabbit models

## TL;DR

A new temporary heart shunt device was tested in animal models and found to be as safe and effective as existing devices, with no lasting damage to blood vessels.

## Contribution

Demonstrates functional equivalence and endothelial safety of a novel intracoronary shunt device in preclinical models.

## Key findings

- No type 5 myocardial infarction occurred in conventional device tests.
- Postoperative CTA showed patent lumens and unobstructed flow in all vessels.
- Endothelial alterations were transient and limited to the acute perioperative period.

## Abstract

This preclinical investigation evaluated the operational equivalence of a temporary intracoronary shunt (TICS) device while documenting patterns of endothelial repair during the perioperative period.

Porcine coronary bypass models were established using off-pump (OPCAB) and on-pump beating-heart surgical approaches. Through a triple randomization design, test devices and predicate counterparts were deployed in left/right coronary arteries. Equivalence was determined at postoperative day 7 through tripartite analysis: 1) sequential laboratory measurements (preoperative to 7-day follow-up), 2) histopathological evaluation of vascular specimens, and 3) angiographic assessment. Extreme-sized device validation employed rabbit carotid arteries (small-caliber vascular bed) and abdominal aortae (large-caliber model), with equivalence criteria encompassing hemodynamic stability (flow velocity, trans-device pressure differentials) and microarchitectural preservation (endothelial integrity, internal elastic lamina continuity).

In the conventional device cohort (12 target vessels), no perioperative type 5 myocardial infarction occurred. Postoperative CTA confirmed patent lumens and unobstructed distal flow in all vessels. Cardiac biomarkers (troponin, CK-MB, myoglobin) showed no significant differences at preoperative, 4h, 8h, 24h, 72h, or 7-day timepoints (P ≥ 0.05). For extreme-sized devices, hemodynamic parameters (mean proximal/distal pressure: test vs. predicate, P ≥ 0.05) and endothelial outcomes, including elastic lamina injury scores, demonstrated equivalence between test and predicate devices.

Functional parity between TICS and predicate devices was established in both porcine and lagomorph models, with observed endothelial alterations demonstrating transient characteristics limited to the acute perioperative window.