Peuster Matthias, Hesse Carola, Schloo Tirza, Fink Christoph, Beerbaum Philipp, von Schnakenburg Christian
Department of Pediatric Cardiology and Pediatric Intensive Care, University of Rostock, Germany.
Biomaterials. 2006 Oct;27(28):4955-62. doi: 10.1016/j.biomaterials.2006.05.029. Epub 2006 Jun 12.
Currently there are no biodegradable stents available for treatment of vascular obstructions in patients with congenital heart defects. This study was performed to evaluate the safety of a corrodible stent produced from pure iron in a peripheral stent design (6-12mm diameter) in a slotted tube design similar to a commercially available 316-L stent which served as control. Both stents were implanted into the descending aorta of 29 minipigs with an overstretch injury without technical problems. Two animals died after the implantation not related to the iron stent. The remaining 27 minipigs were followed for 1-360 days. Histomorphometry and quantitative angiography showed no difference with regard to the amount of neointimal proliferation between 316-L and iron stents. Histopathological examination of heart, lung, spleen, liver, kidney and para-aortic lymphatic nodes demonstrated no signs of iron overload or iron-related organ toxicity. Adjacent to the iron stent struts, there was no evidence for local toxicity due to corrosion products. We conclude that iron is a suitable metal for the production of a large-size degradable stent with no local or systemic toxicity. A faster degradation rate, however, is desirable and further studies have to focus on the modification of the composition and design of the stent to expedite the degradation process.
目前尚无可生物降解的支架用于治疗先天性心脏病患者的血管阻塞。本研究旨在评估一种由纯铁制成的可腐蚀支架的安全性,该支架采用外周支架设计(直径6 - 12毫米),呈开槽管设计,类似于作为对照的市售316 - L支架。两种支架均植入29只小型猪的降主动脉,造成过度拉伸损伤,植入过程无技术问题。植入后有2只动物死亡,与铁支架无关。其余27只小型猪随访1 - 360天。组织形态计量学和定量血管造影显示,316 - L支架和铁支架在内膜增生量方面无差异。对心脏、肺、脾、肝、肾和主动脉旁淋巴结进行组织病理学检查,未发现铁过载或铁相关器官毒性的迹象。在铁支架支柱附近,没有证据表明腐蚀产物会产生局部毒性。我们得出结论,铁是生产大型可降解支架的合适金属,不会产生局部或全身毒性。然而,需要更快的降解速率,进一步的研究必须集中在支架的成分和设计的改进上,以加速降解过程。