Department of Cardiology, KA Rudolfstiftung, Vienna, Austria.
J Endovasc Ther. 2011 Aug;18(4):547-58. doi: 10.1583/10-3347.1.
To evaluate the development of neointimal hyperplasia after implantation of drug-eluting stents (paclitaxel) compared to bare metal stents in porcine internal carotid arteries (ICAs).
While drug-eluting stents have effectively reduced neointimal proliferation in porcine external carotid arteries, the porcine internal carotid artery (ICA) is more sensitive to shear stress and altered flow conditions. Thus, a study was conducted to evaluate bare vs. drug-eluting stents in porcine ICAs. Under general anesthesia, 18 domestic pigs were implanted with paclitaxel-eluting (n = 18) and bare (n = 18) stents in the left and right ICAs, respectively. After 1 and 3 months, control carotid angiography was performed, followed by histopathological and histomorphometric analyses of the stented ICA.
Histopathological results (fibrin deposition, necrosis, inflammation) were similar in the groups at 1 and 3 months. Moreover, the injury score and rate of endothelialization did not differ between the groups. Histomorphometric analysis after 1 month revealed significantly (p<0.05) less neointimal hyperplasia after implantation of paclitaxel-eluting stents. The antiproliferative effect of paclitaxel-eluting stents were maintained during the 3-month follow-up: the neointimal area was 0.7 ± 0.5 vs. 1.2 ± 0.6 mm(2) (p<0.01), the area stenosis was 23.5% ± 13.9% vs. 37.8% ± 14.4% (p<0.01), the maximal neointimal thickness was 0.2 ± 0.1 vs. 0.2 ± 0.9 mm (p<0.05) in paclitaxel-eluting vs. bare stents, respectively. Implantation of paclitaxel-eluting and bare stents did not lead to edge restenosis or vessel remodeling in porcine ICAs at 1 or 3 months.
Compared to bare metal stents, drug-eluting stents implanted in the porcine ICA produced significantly less neointimal hyperplasia.
评估载紫杉醇药物洗脱支架（DES）与裸金属支架（BMS）在猪颈内动脉（ICA）植入后内膜增生的发展情况。
虽然药物洗脱支架在外颈动脉中的新生内膜增生已得到有效抑制，但猪颈内动脉（ICA）对剪切力和血流条件的改变更为敏感。因此，本研究旨在评估 DES 与 BMS 在猪 ICA 中的应用。在全麻下，18 只家猪分别在左右颈内动脉植入紫杉醇洗脱支架（n=18）和裸支架（n=18）。1 个月和 3 个月后，进行颈动脉造影对照，随后对支架植入的颈内动脉进行组织病理学和组织形态学分析。
1 个月和 3 个月时，两组的组织病理学结果（纤维蛋白沉积、坏死、炎症）相似。此外，两组的损伤评分和内皮化率无差异。1 个月时的组织形态学分析显示，植入紫杉醇洗脱支架后内膜增生明显减少（p<0.05）。在 3 个月的随访中，紫杉醇洗脱支架的抗增殖作用得以维持：新生内膜面积为 0.7±0.5mm² vs. 1.2±0.6mm²（p<0.01），面积狭窄率为 23.5%±13.9% vs. 37.8%±14.4%（p<0.01），最大内膜厚度为 0.2±0.1mm vs. 0.2±0.9mm（p<0.05），紫杉醇洗脱支架与裸支架相比。在 1 个月和 3 个月时，猪颈内动脉植入紫杉醇洗脱支架和裸支架均未导致边缘再狭窄或血管重塑。
与裸金属支架相比，DES 植入猪 ICA 后新生内膜增生明显减少。
