BACKGRUND: Besides blocking effect for platelet aggregation, abciximab inhibits inflammatory reaction and proliferation of vascular smooth muscle cell. Alpha-lipoic acid (ALA) is a potent anti-oxidant and has an anti-proliferative effect. OBJECTIVES: The aim of this study was to examine the anti-proliferative and anti-inflammatory effects of dual coating stent with abciximab (outer layer) and ALA (inner layer) in a porcine coronary overstretch restenosis model. METHODS: Pigs were randomized into two groups in which the coronary arteries (10 pigs, 10 coronaries in each group) had either dual coating stent or control MAC stent (AMG, Munich, Germany). Stents were deployed with oversizing (stent/artery ratio 1.3:1) in porcine coronary arteries, and histopathologic analysis was assessed at 28 days after stenting. RESULTS: There was no significant difference in the injury score between the two groups (1.44짹0.59 in dual coating stent group vs. 1.33짹0.66 in control stent group, p=522). In neointima, most inflammatory cells were lymphohistiocytes in both groups. In neointima, lymphohistiocyte count was significantly lower in dual coating stent group compared with control stent group (120짹85 cells vs. 159짹80 cells, p=0.048). There was no significant difference in fibrin score between the two groups (0.16짹0.34 in dual coating stent group vs. 0.25짹0.48 in control stent group, p=0.446). Although neointima area was not significantly different between both groups (1.55짹0.82 mm2 in dual coating stent group vs. 1.40짹0.86 mm2 in control stent group, p=0.447), percent area stenosis was significantly higher in dual coating stent group compared with control stent group (40.7짹15.6% vs. 30.9짹14.7%, p=0.006). CONCLUSIONS: Although dual coating stent with abciximab and ALA showed more neointimal hyperplasia, it was associated with less inflammatory reaction without any difference in arterial healing compared with control stent in a porcine coronary restenosis model.