Mori Masayuki, Sakata Kenji, Nakanishi Chiaki, Nakahashi Takuya, Kawashiri Masa-Aki, Yoshioka Kazuaki, Takuwa Yoh, Okada Hirofumi, Yokawa Jun-Ichiro, Shimojima Masaya, Yoshimuta Tsuyoshi, Yoshida Shohei, Yamagishi Masakazu, Hayashi Kenshi
Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
Department of Molecular Vascular Physiology, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Isikawa, 920-8641, Japan.
Heart Vessels. 2017 Oct;32(10):1244-1252. doi: 10.1007/s00380-017-0992-5. Epub 2017 May 17.
Although Nobori, with a bioresorbable polymer and biolimus A9 abluminal coating, has unique characteristics, few data exist regarding endothelialization early after implantation. Fifteen Nobori and 14 control bare-metal stents (S-stent™) were implanted in 12 pigs. Histopathology of stented segments, inflammation, and intimal fibrin content was evaluated on the 2nd and 14th day after implantation. On the 2nd day, endothelial cells were morphologically and immunohistologically confirmed on the surface of both stents, although some inflammatory cells might be involved. Stent surface endothelialization evaluated with a scanning electron microscope showed partial cellular coverage in both stents. On the 14th day, neointimal thickness and percentage of the neointimal area were significantly lower in Nobori than in S-stent™ (51.4 ± 4.5 vs. 76.4 ± 23.6 µm, p < 0.05 and 10.8 ± 2.6 vs. 14.1 ± 4.2%, p < 0.01). No significant differences were found in these parameters on the 2nd day (17.3 ± 14.9 vs. 26.7 ± 13.6 µm and 3.7 ± 3.0 vs. 6.7 ± 3.7%), in inflammatory and intimal fibrin content scores. These results demonstrate that endothelialization could occur early after Nobori implantation with similar inflammatory reaction to bare-metal stents, probably contributing to low frequency of in-stent thrombosis and restenosis.
尽管采用生物可吸收聚合物和生物雷帕霉素A9管腔外涂层的Nobori支架具有独特特性,但关于植入后早期内皮化的数据却很少。将15个Nobori支架和14个对照裸金属支架(S-stent™)植入12头猪体内。在植入后的第2天和第14天评估支架段的组织病理学、炎症和内膜纤维蛋白含量。在第2天,尽管可能有一些炎症细胞参与,但在两种支架表面均通过形态学和免疫组织学证实了内皮细胞的存在。用扫描电子显微镜评估的支架表面内皮化显示两种支架均有部分细胞覆盖。在第14天,Nobori支架的新生内膜厚度和新生内膜面积百分比显著低于S-stent™(分别为51.4±4.5 vs. 76.4±23.6μm,p<0.05;以及10.8±2.6 vs. 14.1±4.2%,p<0.01)。在第2天,这些参数(分别为17.3±14.9 vs. 26.7±13.6μm和3.7±3.0 vs. 6.7±3.7%)、炎症和内膜纤维蛋白含量评分方面未发现显著差异。这些结果表明,Nobori支架植入后早期可发生内皮化,且炎症反应与裸金属支架相似,这可能是其支架内血栓形成和再狭窄发生率较低的原因。