Halwani Dina O, Anderson Peter G, Lemons Jack E, Jordan William D, Anayiotos Andreas S, Brott Brigitta C
The University of Alabama at Birmingham, Interventional Cardiology, FOT 907 510 20th Street So., Birmingham, AL 35294, USA.
J Invasive Cardiol. 2010 Nov;22(11):528-35.
To evaluate retrieved bare metal vascular stents and surrounding tissue.
Limited information is available regarding the condition of stent surfaces and their interaction with vascular tissue following implantation. Corrosion of stents presents two main risks: release of metallic ions into tissue and deterioration of the mechanical properties of stents which may contribute to fracture. Release of heavy metal ions could alter the local tissue environment leading to up-regulation of inflammatory mediators and promote in-stent restenosis.
Nineteen cases were collected from autopsy, heart explants for transplant, and vascular surgery (23 vessels containing 33 bare metal stents). A method was developed for optimal tissue dissolution and separation of the stent/tissue components without inducing stent corrosion. When available, chemical analysis was performed to assess metallic content in both the control and dissolved tissue solutions. Electron microscopy and digital optical microscopy imaging were used to evaluate stents.
Twelve of the 33 stents showed varying degrees of corrosion. Metallic levels in the tissue surrounding the corroded stents were significantly higher (0.5-3.0 mcg/cm² stent) than in control solutions (0-0.30 mcg/cm² stent) and in tissue surrounding stents that did not undergo corrosion (0- 0.20 mcg/cm² stent).
Corrosion of some retrieved stents is described which leads to transfer of heavy metal ions into surrounding tissue. The contribution of this metallic ion release to the mechanisms of in-stent restenosis as well as its effect on the mechanical properties of stents is unknown and requires further investigation.
评估回收的裸金属血管支架及周围组织。
关于植入后支架表面状况及其与血管组织相互作用的信息有限。支架腐蚀存在两个主要风险：金属离子释放到组织中以及支架机械性能恶化，这可能导致支架断裂。重金属离子的释放可能会改变局部组织环境，导致炎症介质上调并促进支架内再狭窄。
从尸检、心脏移植外植体和血管手术中收集了19例病例（23条血管，包含33个裸金属支架）。开发了一种方法，可实现最佳的组织溶解以及支架/组织成分的分离，同时不会引发支架腐蚀。如有可能，进行化学分析以评估对照溶液和溶解组织溶液中的金属含量。使用电子显微镜和数字光学显微镜成像来评估支架。
33个支架中有12个显示出不同程度的腐蚀。腐蚀支架周围组织中的金属含量（0.5 - 3.0微克/平方厘米支架）显著高于对照溶液（0 - 0.30微克/平方厘米支架）以及未发生腐蚀的支架周围组织（0 - 0.20微克/平方厘米支架）。
描述了一些回收支架的腐蚀情况，这种腐蚀会导致重金属离子转移到周围组织中。这种金属离子释放对支架内再狭窄机制的影响及其对支架机械性能的作用尚不清楚，需要进一步研究。
