Wang Lin, Zhu Yue-Qi, Cheng Ying-Sheng, Cui Wen-Guo, Chen Ni-Wei
Department of Radiology, The Tenth Affiliated People's Hospital, Shanghai Tong Ji University Faculty of Medicine, Shanghai, China; Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital600 Yi Shan Road, Shanghai, China.
Turk J Gastroenterol. 2014 Dec;25 Suppl 1:69-74. doi: 10.5152/tjg.2014.6611.
BACKGROUND/AIMS: To investigate whether temporary placement of a paclitaxel or rapamycin eluting stent is more effective to reduce stenting induced inflammatory reaction and scaring than a bared stent in benign cardia stricture models.
Eighty dog models of stricture were randomly divided into a control group (CG, n=20, no stent insertion), a bare stent group (BSG, n=20), a paclitaxel eluting (Pacl-ESG, n=20) and a rapamycin eluting stent group (Rapa-ESG, n=20), with one-week stent retention. Lower-oesophageal-sphincter pressure (LOSP), 5-minute barium height (5-mBH) and cardia diameter were assessed before, immediately after the procedure, and regularly for 6 months. Five dogs in each group were euthanized for histological examination at each follow-up assessment.
Stent insertion was well tolerated, with similar migration rates in three groups. At 6 months, LOSP and 5-mBH improved in Pacl-ESG and Rapa-ESG compared to BSG (p<0.05), with no difference between Pacl-ESG and Rapa-ESG (p>0.05). Cardia kept more patency in the Pacl-ESG and Rapa-ESG than in BSG (p<0.05). Reduced peak inflammatory reactions and scarring occurred in the Pacl-ESG and Rapa-ESG compared to BSG (p<0.05), with a similar outcome in the Pacl-ESG and Rapa-ESG (p>0.05).
Paclitaxel or rapamycin-eluting stents insertion led to better outcomes than bare stents in benign cardia stricture models.
背景/目的:在良性贲门狭窄模型中,研究临时置入紫杉醇或雷帕霉素洗脱支架在减轻支架置入引起的炎症反应和瘢痕形成方面是否比裸支架更有效。
80只犬狭窄模型随机分为对照组(CG,n = 20,未置入支架)、裸支架组(BSG,n = 20)、紫杉醇洗脱支架组(Pacl - ESG,n = 20)和雷帕霉素洗脱支架组(Rapa - ESG,n = 20),支架保留1周。在术前、术后即刻及术后6个月定期评估食管下括约肌压力(LOSP)、5分钟钡剂高度(5 - mBH)和贲门直径。每组在每次随访评估时处死5只犬进行组织学检查。
支架置入耐受性良好,三组的移位率相似。6个月时,与BSG相比,Pacl - ESG和Rapa - ESG组的LOSP和5 - mBH有所改善(p < 0.05),Pacl - ESG和Rapa - ESG组之间无差异(p > 0.05)。与BSG相比,Pacl - ESG和Rapa - ESG组的贲门保持更通畅(p < 0.05)。与BSG相比,Pacl - ESG和Rapa - ESG组的峰值炎症反应和瘢痕形成减少(p < 0.05),Pacl - ESG和Rapa - ESG组结果相似(p > 0.05)。
在良性贲门狭窄模型中,置入紫杉醇或雷帕霉素洗脱支架比裸支架效果更好。