Song Xian-tao, Zhu Hua-gang, Yang Xing-sheng, Yuan Fei, Lü Shu-zheng
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2011 Nov;39(11):997-1004.
To investigate the impact of the stents coated with sirolimus and anti-CD34 antibody on the short-term re-endothelialization and the long-term restenosis in Chinese Minipigs.
Three different types of stents [bare-metal stent (BMS), sirolimus-eluting stent (SES) and anti-CD34 antibody and sirolimus-coated stent (ASES)] were randomly implanted in the coronary arteries of 22 Chinese Minipigs. At two weeks after stenting, coronary angiography and optical coherence tomography (OCT) were performed in 10 experimental animals. At three months after stenting, coronary angiography and OCT were performed in the remaining 12 experimental animals. Histopathologic examination was performed on the coronary artery segments containing stent after the animals were executed.
(1) No in-stent thrombosis and parietal thrombus were found by coronary angiography, OCT and histopathologic examination at two weeks post stenting. OCT analysis showed that the covered ratio of stent struts by neointima in ASES group was higher than in SES group [(55.56 ± 35.27)% vs. (41.82 ± 23.28)%, P < 0.05]. The mean thickness of neointima in ASES group was significantly higher than in SES group [(89.0 ± 5.0) µm vs. (32.0 ± 4.9) µm, P < 0.01] and BMS group [(89.0 ± 5.0) µm vs. (44.0 ± 7.2) µm, P < 0.01]. Histopathologic and scanning electron microscopy examinations demonstrated that the covering level and quality of stent struts by neointima in BMS and ASES group were both better than in SES group. (2) At three months follow-up, quantitative coronary angiography analysis found that late in-stent lumen loss in ASES group was significantly lower than in BMS group [(0.18 ± 0.06) mm vs.(0.35 ± 0.06) mm, P < 0.05]. OCT analysis showed that the percent neointimal hyperplasia in ASES and SES group was significantly lower than in BMS group [(34.75 ± 2.64)% and (35.63 ± 2.07)% vs. (48.28 ± 3.25)%, both P < 0.01]. Histopathologic analysis demonstrated that the percent areal restenosis of ASES and SES group were both significantly lower than that of BMS group [(28.65 ± 5.64)% and (29.33 ± 6.07)% vs. (46.18 ± 8.25)%, both P < 0.05].
The stents coated with anti-CD34 antibody and sirolimus can attenuate the inhibitory effect of sirolimus on the re-endothelialization at two weeks after stenting and the anti-hyperplasia effect of sirolimus at three months after stenting.
研究西罗莫司和抗CD34抗体涂层支架对中国小型猪短期再内皮化及长期再狭窄的影响。
将三种不同类型的支架[裸金属支架(BMS)、西罗莫司洗脱支架(SES)和抗CD34抗体与西罗莫司涂层支架(ASES)]随机植入22只中国小型猪的冠状动脉。支架置入后两周,对10只实验动物进行冠状动脉造影和光学相干断层扫描(OCT)。支架置入后三个月,对其余12只实验动物进行冠状动脉造影和OCT。动物处死后,对含支架的冠状动脉节段进行组织病理学检查。
(1)支架置入后两周,冠状动脉造影、OCT及组织病理学检查均未发现支架内血栓及壁内血栓。OCT分析显示,ASES组支架小梁内膜覆盖率高于SES组[(55.56±35.27)%对(41.82±23.28)%,P<0.05]。ASES组内膜平均厚度显著高于SES组[(89.0±5.0)μm对(32.0±4.9)μm,P<0.01]和BMS组[(89.0±5.0)μm对(44.0±7.2)μm,P<0.01]。组织病理学和扫描电子显微镜检查表明,BMS组和ASES组支架小梁内膜覆盖程度和质量均优于SES组。(2)随访三个月时,定量冠状动脉造影分析发现,ASES组支架晚期管腔丢失显著低于BMS组[(0.18±0.06)mm对(0.35±0.06)mm,P<0.05]。OCT分析显示,ASES组和SES组内膜增生百分比显著低于BMS组[(34.75±2.64)%和(35.63±2.07)%对(48.28±3.25)%,均P<0.01]。组织病理学分析表明,ASES组和SES组面积再狭窄百分比均显著低于BMS组[(28.65±5.64)%和(29.33±6.07)%对(46.18±8.25)%,均P<0.05]。
抗CD34抗体与西罗莫司涂层支架可减弱西罗莫司在支架置入后两周对再内皮化的抑制作用以及在支架置入后三个月对增生的抑制作用。