Τίτλος:
Stents covered by an autologous arterial graft in porcine coronary
arteries: feasibility, vascular injury and effect on neointimal
hyperplasia
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: The use of stents has improved results after balloon coronary
angioplasty. Several materials have been proposed for covering the
metallic surface of the stent to reduce the rate of subacute thrombosis
and restenosis. In our institution, an autologous arterial graft was
used for covering the external surface of a conventional stent. The
angiographic and histological response in a porcine coronary artery
model was investigated. Methods: An autologous arterial graft was
removed from the femoral artery and carefully prepared. Subsequently, a
conventional stent was covered externally by the arterial graft.
Twenty-two covered stents and 22 uncovered regular stents were implanted
alternatively in the coronary arteries of 22 pigs. One animal died
immediately after the procedure, due to thrombus formation in the
uncovered stent. Six animals were sacrificed at seven days and the
remaining animals were sacrificed at two months. Before the sacrifice,
coronary angiography was performed in all animals. Results: Thrombosis
was detected in two control segments and in one covered stented segment.
After seven days, the luminal surface of the covered stents was covered
by a new endothelial layer in contrast to partial endothelial cell
appearance in the: control group. The angiographic parameters were
similar between the two groups. Histologically, the covered stents were
associated with less vascular injury compared to uncovered stents. In
covered stents a trend towards reduction of maximal intimal hyperplasia
was detected (covered: 116.6+/-37.75 vs uncovered: 150.25+/-16.81 mu m,
p=0.08); also the thickness of the arterial media was reduced (covered:
21.34+/-10.28 vs uncovered: 102.63+/-18.71 mu m, p=0.02). The luminal
and vessel areas were similar in the two groups. Conclusions: The
preparation and implantation of the autologous arterial graft-covered
stent is technically safe and feasible. This type of covered stent
results in accelerated endothelialization, less vascular injury,
thinning of the arterial media and a trend to reduce the intimal
hyperplasia in normal coronary arteries. (C) 1999 Elsevier Science B.V.
All rights reserved.
Συγγραφείς:
Stefanadis, C
Toutouzas, K
Tsiamis, E
Vlachopoulos, C and
Vaina, S
Tsekoura, D
Haldi, L
Stefanadi, E
Gravanis, M
and Toutouzas, P
Περιοδικό:
Cardiovascular Research
Εκδότης:
ELSEVIER SCIENCE BV
Λέξεις-κλειδιά:
vasculature; arteries; histopathology; restenosis; stents; thrombosis
DOI:
10.1016/S0008-6363(98)00211-9
