Innovation Beyond DES:
The DynamX Coronary Bioadaptor System
The DynamX™ Drug Eluting Coronary Bioadaptor System is a significant innovation in the treatment of coronary artery disease. Going beyond drug-eluting stents (DES), DynamX represents one of the most significant breakthroughs in implant design in the past 30 years.
DynamX is the first coronary artery implant designed to deliver sustained superior clinical outcomes by restoring normal vessel functions. The device uniquely adapts to vessel physiology to restore:
- Positive adaptive remodeling
- Vessel function
- Vessel dynamic compliance
The loss of vessel movement, which occurs with DES, has been associated with major adverse cardiac events (MACE).13 By adapting to the vessel, DynamX offers the potential to reduce the incidence of MACE.
How DynamX Works
DynamX is a cobalt chromium implant coated in a proven bioresorbable polymer and a low-dose anti-proliferative drug. Deployed similar to a DES, it initially supports the coronary artery during vessel healing, demonstrating excellent radial strength.
Over six months, the polymer resorbs, freeing unique uncaging elements which allow DynamX to move along with the natural motion of the vessel, including pulsatile motion, rotation, flexion, and a return toward baseline angulation.
These uncaging elements are located at low stress regions of the device’s sinusoidal rings that can move safely and independently within the frame of the bioadaptor. Once uncaged, DynamX allows the vessel to move naturally and respond to patients’ physiologic requirements in ways that traditional DES has been unable to deliver for millions of patients.
Implanted similar to drug-eluting stent
Drug elutes over 3 months
Polymer coating resorbs over 6 months
Uncaging elements release once coating is resorbed
DynamX is uniquely designed to adapt to vessel physiology, activity level and disease progression
This device is very promising and may actually mitigate the problems of the annually occurring events we see with DES.
Stefan Verheye, MD, PhD
Co-principal investigator, DynamX Mechanistic Clinical Study, senior interventional cardiologist, Antwerp Cardiovascular Centre/ZNA Middleheim, Belgium
View DynamX in Action
Key DynamX Features
Hover over the icons to learn more about DynamX design.
*71µm strut thickness for 2.25mm – 3.0mm diameters
Unique Design Beyond Drug-Eluting Stents (DES)
Maintains Ability for Positive Adaptive Remodeling
Blood vessels change in size and structure over time. For example, when the blood flow lumina of coronary arteries narrow due to a build-up of fats, cholesterol and other substances from atherosclerosis, arteries expand in diameter. This expansion is the body’s compensating response in order to maintain the blood flow lumen area and is known as positive adaptive remodeling.
Traditional stents are designed to safely and effectively open narrowed vessels, but they are rigid and “cage” the artery. This prevents arteries from exhibiting their natural response to expand and compensate for disease progression.
Unlike traditional stents, the unique uncaging elements of the DynamX Bioadaptor allow it to expand along with the vessel, maintaining the ability of the coronary artery to exhibit positive adaptive remodeling.
2nd Generation DES
Traditional DES open the narrowed vessel but cage the lesion area. This maintains the vessel and device area but the lumen area decreases as the disease continues to progress.
DynamX Bioadaptor opens narrowed vessels and then uncages, allowing the coronary artery to compensate for continued disease progression. The device expands with the artery at the lesion site, maintaining the lumen area and good blood flow.
|DynamX Mechanistic Clinical Study IVUS Analysis
|Post-Procedure||9- & 12-Month Follow-Up||Change from Post-Procedure||P Value|
|Mean Vessel Area (mm2)||14.11 ± 2.99||14.54 ± 3.12||3%||0.02|
|Mean Bioadaptor Area (mm2)||7.39 ± 1.20||7.74 ± 1.46||5%||0.0005|
|Mean Lumen Area (mm2)||7.39 ± 1.20||7.36 ± 1.31||0%||0.59|
Vessel and implant grow to maintain vessel lumen – positive adaptive remodeling
Restores Vessel Function
Allows for Normal Vessel Pulsatility and Motion
Maintaining vascular homeostasis elicits biologic responses that protect against atherosclerosis. The vessel’s ability to stretch radially in response to cyclic strain supports this phenomenon.12
Traditional DES reduce vessel compliance by caging the lesion area, severely reducing normal vessel motion.
Unlike traditional DES, DynamX Bioadaptor has enabled treated vessels to exhibit normal pulsatility and motion.7 The unique uncaging elements are designed to uncouple over six months and allow for normal response to cyclic strain.
Artery cross-section using stationary OCT through multiple cardiac cycles
Single cycle pulsatility highlighted (orange and blue lines) among multiple pulsatile cardiac cycles
Lumen area: 4.96 mm2
Bioadaptor area: 6.05 mm2
Lumen area: 5.65 mm2
Bioadaptor area: 6.59 mm2
increase in lumen area
increase in bioadaptor area
Clinical Case Example from DynamX Mechanistic Clinical Study
Comparison of vessel pulsatility
Uncaged DynamX Bioadaptor allows for normal vessel pulsatility and motion unlike traditional DES that cage the artery
DynamX Uncaged – Pulsatility Restored
DES – Vessel Caged
Stationary IVUS imaging of porcine coronary artery during systole and diastole
Allows for Return Towards Baseline Vessel Angulation
In contrast to the acute beneficial effects of radially expanding a narrowed artery with a stent, straightening of an artery with the same rigid stent may contribute to restenosis and has been shown to be a predictor of major cardiac adverse events (MACE).4 Subsequent straightening of a vessel compared to vessel angulation immediately following implantation is significantly correlated with the occurrence of MACE.4