Nishi S, Nakayama Y, Ueda H, Ishikawa M, Matsuda T
Department of Neurosurgery, Kitano Medical Institute and Hospital; Osaka, Japan.
Interv Neuroradiol. 2000 Nov 30;6 Suppl 1(Suppl 1):175-80. doi: 10.1177/15910199000060S127. Epub 2001 May 15.
The use of stents improves the result after balloon coronary angioplasty. Restenosis due to neointimal hyperplasia and proliferation of smooth muscle cells are, however, a concern. In the present report, we studied the prevention of restenosis to allow endothelial cell migration and growth to proceed through micropores using our developed stent graft with micropored segmented polyurethane (SPU) thin film in a normal beagle model. Our developed stent graft was made from Palmaz stent and micropored SPU thin film. The SPU film was arranged into four different micropore densities around the circumference: no micropores, arrangement 4; micropores of 30mum in diameter with an orderly distance of 250mum; (arrangement 1), 500mum; (arrangement 2) and 125mum (arrangement 3) between the neighboring two pores. Micropores were made using the Excimer laser ablation technique. The Palmaz stent was wrapped with micropored film, sutured, and glued with DMF (dimethyl formamide) under aid of a microscope. These stents were placed in the common carotid arteries of beagles (n = 5). They were sacrificed at 1 month, and a histological study and scanning electron microscopy study were performed for evaluation of endoluminal endothelialization. In 10 arteries applied with stent grafts, there was no severe stenosis although it did occur to some extent. All stented arteries were patent. Endothelial cell migration and growth through micropores were observed histologically on micropored SPU thin film in this model, which did not affect the intraluminal diameter. In most non-porous regions, significant thrombi were found between the SPU film and the neointimal layer. On the other hand, in the porous region, little thrombosis was observed except in the lowest density region. In 125mum of distance between two neighboring pores, the neointimal layer was the thinnest, which was suitable for wide intraluminal space after placement of a stent graft. Endothelial cell migration and growth through micropores were confirmed in the animal model using our developed micropored stent graft. The proceeding of their migration was controlled by micropore density under a constant micropore diameter. The stent graft with micropored SPU thin film is promising for the prevention of restenosis due to neointimal hyperplasia.
支架的使用改善了球囊冠状动脉成形术后的效果。然而,由新生内膜增生和平滑肌细胞增殖引起的再狭窄仍是一个问题。在本报告中,我们在正常的比格犬模型中,使用我们研发的带有微孔分段聚氨酯(SPU)薄膜的支架移植物,研究了通过微孔允许内皮细胞迁移和生长来预防再狭窄的方法。我们研发的支架移植物由Palmaz支架和微孔SPU薄膜制成。SPU薄膜在圆周周围排列成四种不同的微孔密度:无微孔(排列4);直径为30μm的微孔,相邻两个微孔之间的有序间距为250μm(排列1)、500μm(排列2)和125μm(排列3)。微孔采用准分子激光烧蚀技术制作。Palmaz支架用微孔薄膜包裹,在显微镜辅助下缝合并用二甲基甲酰胺(DMF)粘贴。将这些支架放置在比格犬的颈总动脉中(n = 5)。在1个月时将它们处死,并进行组织学研究和扫描电子显微镜研究以评估腔内内皮化情况。在应用了支架移植物的10条动脉中,虽然在一定程度上出现了再狭窄,但没有严重狭窄。所有植入支架的动脉均保持通畅。在该模型中,通过组织学观察到内皮细胞通过微孔在微孔SPU薄膜上迁移和生长,这并未影响管腔直径。在大多数无孔区域,在SPU薄膜和新生内膜层之间发现了大量血栓。另一方面,在多孔区域,除了最低密度区域外,几乎未观察到血栓形成。在相邻两个微孔之间的距离为125μm时,新生内膜层最薄,这适合于植入支架移植物后的宽管腔空间。使用我们研发的微孔支架移植物在动物模型中证实了内皮细胞通过微孔的迁移和生长。在恒定的微孔直径下,它们的迁移进程由微孔密度控制。带有微孔SPU薄膜的支架移植物在预防因新生内膜增生引起的再狭窄方面很有前景。