Haskal Z J, Brennecke L H
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Radiology. 1999 Dec;213(3):853-9. doi: 10.1148/radiology.213.3.r99dc24853.
To evaluate the safety, efficacy, and tissue response associated with Wallstents covered with polyethylene terephthalate (PETP) compared with those associated with uncovered Wallstents for creation of transjugular intrahepatic portosystemic shunts (TIPS) in a porcine model.
Thirteen TIPS were created in 13 minipigs: eight with PETP-covered Wallstents, five with standard Wallstents. Shunt venography was performed at 5-8 weeks, and necropsy was performed at 7-8 weeks. Histopathologic, immunohistochemical, and scanning electron microscopic examinations were performed.
Mean shunt stenoses of the control and graft groups were 45% and 53%, respectively. Graft stenoses involved the entire graft-bearing segment, whereas bare stent stenoses were localized within the liver tract. Myofibroblast and extracellular collagen matrix proliferation encompassed both control and graft-covered stents. There was one graft TIPS occlusion. One control TIPS stenosis was due to transstent proliferation of normal porcine hepatic tissue. A small focus of bile staining was seen on the abluminal surface of one TIPS, which was a patent PETP-lined shunt.
PETP graft TIPS provided equal, but not superior, patency to that of bare stent TIPS. The pattern of PETP TIPS graft healing differed from that of bare stents but was similar to that reported with other polyester graft vascular implants and consisted of diffuse transmural penetration and paving of the graft surface by extracellular collagen matrix and myofibroblasts.
在猪模型中，评估与聚对苯二甲酸乙二酯（PETP）覆盖的Wallstents相关的安全性、有效性和组织反应，并与未覆盖的Wallstents用于创建经颈静脉肝内门体分流术（TIPS）的情况进行比较。
在13只小型猪中创建了13个TIPS：8个使用PETP覆盖的Wallstents，5个使用标准Wallstents。在5 - 8周时进行分流静脉造影，并在7 - 8周时进行尸检。进行了组织病理学、免疫组织化学和扫描电子显微镜检查。
对照组和移植物组的平均分流狭窄分别为45%和53%。移植物狭窄累及整个含移植物段，而裸支架狭窄局限于肝内段。肌成纤维细胞和细胞外胶原基质增殖在对照组和移植物覆盖的支架中均有出现。有1个移植物TIPS闭塞。1个对照组TIPS狭窄是由于正常猪肝组织跨支架增殖所致。在1个TIPS的腔外表面可见一小片胆汁染色区域，该TIPS是一个有PETP内衬的通畅分流。
PETP移植物TIPS的通畅性与裸支架TIPS相当，但并不更优。PETP TIPS移植物的愈合模式与裸支架不同，但与其他聚酯移植物血管植入物的报道相似，包括细胞外胶原基质和肌成纤维细胞对移植物表面的弥漫性透壁穿透和覆盖。
