Avino A, Johnson B, Bandyk D, Back M, Roth S, Kudryk B, Cantor A
Department of Surgery, University of South Florida College of Medicine, Tampa, USA.
J Endovasc Ther. 2000 Dec;7(6):469-78. doi: 10.1177/152660280000700607.
To evaluate placement of polyester (Dacron) coverings on nitinol stents implanted in the canine aorta to determine the effect on cross-sectional lumen area, development of intimal hyperplasia, device endothelialization, and flow hemodynamics.
Ten polyester-covered and 10 uncovered nitinol stents (60-mm length, 10- or 12-mm diameter) were deployed percutaneously in the normal infrarenal aorta of 20 adult mongrel dogs using random assignment. Angiography, intravascular ultrasound (IVUS), and duplex ultrasound performed at device deployment and before explantation at 6 weeks were used to measure aorta/device diameter and cross-sectional area. Pressure-perfusion-fixed aortic segments were compared for surface endothelialization (CD31 staining) and for thickness of neointimal formation.
All 20 endoluminal devices were accurately positioned in the infrarenal aorta without early or delayed evidence of device thrombosis, significant lumen narrowing, or device deformity. IVUS and duplex scanning identified no anatomical stenosis in either the covered or the bare devices by duplex ultrasound; peak systolic velocity measurements were similar (106+/-25 cm/s in the covered stent versus 96+/-25 cm/s for bare stents, p > 0.05). Mean neointimal thickness was significantly greater (p < 0.005) in the covered (326+/-145 microm) compared with the bare (219+/-62 microm) stents. Intima-to-media height ratios were greater in the covered stents (3.0+/-1.1 compared with 1.1+/-0.2, p < 0.003). Mean surface area endothelialization in the proximal, middle, and distal sections of each device was similar (p > 0.05) in covered (59%, 56%, and 69%) and bare (59%, 65%, and 53%) stents.
Deployment and balloon dilation of a covered nitinol stent in a nondiseased canine aorta increased neointimal development compared with an uncovered stent, but overall lumen cross-sectional area was preserved. No differences in device patency, intradevice thrombus formation, flow hemodynamics, or luminal endothelialization were demonstrated, despite a thicker intradevice neointima induced by the polyester covering.
评估在植入犬主动脉的镍钛诺支架上放置聚酯（涤纶）覆盖物，以确定其对管腔横截面积、内膜增生发展、装置内皮化及血流动力学的影响。
采用随机分组的方法，将20个成年杂种犬正常肾下腹主动脉经皮植入10个带聚酯覆盖物的镍钛诺支架和10个无覆盖物的镍钛诺支架（长度60 mm，直径10或12 mm）。在装置植入时及6周后取出前进行血管造影、血管内超声（IVUS）和双功超声检查，以测量主动脉/装置直径和横截面积。对压力灌注固定的主动脉节段进行表面内皮化（CD31染色）和新生内膜形成厚度的比较。
所有20个腔内装置均准确置于肾下腹主动脉，未出现装置血栓形成、明显管腔狭窄或装置变形的早期或延迟迹象。IVUS和双功扫描显示，带覆盖物和无覆盖物的装置在双功超声检查中均未发现解剖学狭窄；收缩期峰值流速测量结果相似（带覆盖物支架为106±25 cm/s，无覆盖物支架为96±25 cm/s，p>0.05）。与无覆盖物支架（219±62μm）相比，带覆盖物支架（326±145μm）的平均新生内膜厚度明显更大（p<0.005）。带覆盖物支架的内膜/中膜高度比更大（分别为3.0±1.1和1.1±0.2，p<0.003）。每个装置近端、中部和远端节段的平均表面面积内皮化在带覆盖物支架（分别为59%、56%和69%）和无覆盖物支架（分别为59%、65%和53%）中相似（p>0.05）。
与无覆盖物支架相比，在未患病的犬主动脉中植入带覆盖物的镍钛诺支架并进行球囊扩张会增加新生内膜的形成，但总体管腔横截面积得以保留。尽管聚酯覆盖物导致装置内新生内膜增厚，但在装置通畅性、装置内血栓形成、血流动力学或管腔内内皮化方面未发现差异。
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