Zhu Yue-Qi, Yang Kai, Edmonds Laura, Wei Li-Ming, Zheng Reila, Cheng Ruo-Yu, Cui Wen-Guo, Cheng Ying-Sheng
Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China.
Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, China and Nanotechnology Engineering, University of Waterloo, Ontario, Canada.
Therap Adv Gastroenterol. 2017 Jan;10(1):11-19. doi: 10.1177/1756283X16671670. Epub 2016 Oct 13.
We determined the feasibility of, and tissue response to silicone-covered biodegradable magnesium- and plastic-stent insertion into the esophagus in rabbits.
The mechanical compression-recovery characteristics and degradation behaviors of the magnesium stent were investigated . A total of 45 rabbits were randomly divided into a magnesium- ( = 15) and a plastic- ( = 15) stent group, and underwent stent insertion into the lower third of the esophagus under fluoroscopic guidance; a control group ( = 15) did not undergo the intervention. Esophagography was performed at 1, 2, and 4 weeks. Five rabbits in each group were euthanized at each time point for histological examination.
Silicone-covered magnesium stents showed similar radial force to plastic stents ( > 0.05). The magnesium stents degraded rapidly in an acidic solution, but 90.2% ± 3.1% of the residual mass was maintained after a 2-week degradation in a solution with a pH of 4.0. All stent insertions were well tolerated. Magnesium stents migrated in six rabbits (one at 1 week, one at 2 weeks and four at 4 weeks), and plastic stents migrated in three rabbits (one at 2 weeks and two at 4 weeks; > 0.05). Esophageal wall remodeling (thinner epithelial and smooth muscle layers) was similar in both stented groups ( > 0.05), and the esophagus wall was found to be significantly thinner in the stented groups than in the control group ( < 0.05). Esophageal injury and collagen deposition following stent insertion were similar and did not differ from the control group ( > 0.05).
Esophageal silicone-covered magnesium stents provided reliable support for at least 2 weeks, with acceptable migration rates and without causing severe injury or tissue reaction compared with plastic stents.
我们确定了在兔食管中插入硅胶覆盖的可生物降解镁支架和塑料支架的可行性以及组织反应。
研究了镁支架的机械压缩恢复特性和降解行为。总共45只兔被随机分为镁支架组（n = 15）和塑料支架组（n = 15），在透视引导下将支架插入食管下三分之一处；对照组（n = 15）不进行干预。在第1、2和4周进行食管造影。每组在每个时间点处死5只兔进行组织学检查。
硅胶覆盖的镁支架显示出与塑料支架相似的径向力（P>0.05）。镁支架在酸性溶液中迅速降解，但在pH值为4.0的溶液中降解2周后，仍保留90.2%±3.1%的残余质量。所有支架植入均耐受良好。镁支架在6只兔中发生移位（1只在1周时，1只在2周时，4只在4周时），塑料支架在3只兔中发生移位（1只在2周时，2只在4周时；P>0.05）。两个支架植入组的食管壁重塑（上皮和平滑肌层变薄）相似（P>0.05），且发现支架植入组的食管壁明显比对照组薄（P<0.05）。支架植入后的食管损伤和胶原沉积相似，与对照组无差异（P>0.05）。
食管硅胶覆盖的镁支架提供了至少2周的可靠支撑，移位率可接受，与塑料支架相比，不会引起严重损伤或组织反应。
