Sigl Martin, Dudeck Oliver, Jung Johannes, Koelble Heinz, Amendt Klaus
1 Diakonissenkrankenhaus Mannheim, Mannheim, Germany.
2 Hirslanden Private Hospital Group, Radiology Clinic, Zurich, Switzerland.
Vasa. 2017 Oct;46(6):446-451. doi: 10.1024/0301-1526/a000657. Epub 2017 Aug 21.
A new stent system was studied in a porcine model to evaluate its feasibility for spot-stenting of the femoropopliteal artery.
In a preliminary study in a single pig, handling and mechanical features of the novel multiple stent delivery system were tested. The Multi-LOC system demonstrated great feasibility regarding its pushability, trackability, and crossability. Excellent visibility of the individual stents allowed exact anatomically controlled implantation. In our main study, four to five short Multi-LOC stents (13 mm long) were implanted into the femoropopliteal arteries of six domestic pigs and long (60 to 100 mm) self-expandable nitinol stents were implanted into the same target vessel contralaterally to allow for intraindividual comparison. After four weeks survival under dual antiplatelet treatment, control angiography was performed. The animals were euthanized, stented vessels were explanted, and histologic sections were examined for the presence of neointimal formation.
Multi-LOC stents demonstrated no occlusion of the femoropopliteal axis (0 vs. 1 occlusion distal to a control stent), no stent fractures (0 out of 26 vs. 2 out of 6 control stents), and lower percentage diameter stenosis (0.564 ± 0.056 vs. 0.712 ± 0.089; p = 0.008) and length of stenosis (19.715 ± 5.225 vs. 39.397 ± 11.182; p = 0.007) compared to a standard control stent, which was similar in total length to the multiple stented artery segment. Histological examination confirmed myointimal hyperplasia underlying in-stent stenosis.
The multiple stent delivery system was studied in a porcine model, which demonstrated its feasibility. Preclinical experience revealed favourable results concerning stent fracture, restenosis, and patency of spot-stented femoropopliteal arteries.
在猪模型中研究了一种新型支架系统，以评估其对股腘动脉进行局部支架植入的可行性。
在对一头猪的初步研究中，测试了新型多支架输送系统的操作和机械特性。Multi-LOC系统在推送性、可跟踪性和通过性方面显示出极大的可行性。单个支架的可视性极佳，可实现精确的解剖学控制植入。在我们的主要研究中，将四至五个短的Multi-LOC支架（13毫米长）植入六头家猪的股腘动脉，并在对侧同一目标血管中植入长（60至100毫米）的自膨胀镍钛诺支架，以便进行个体内比较。在双重抗血小板治疗下存活四周后，进行对照血管造影。对动物实施安乐死，取出植入支架的血管，并检查组织切片中是否存在新生内膜形成。
Multi-LOC支架显示股腘动脉轴无闭塞（0例对比对照支架远端1例闭塞），无支架断裂（26个中0例对比6个对照支架中2例），与标准对照支架相比，直径狭窄百分比更低（0.564±0.056对比0.712±0.089；p = 0.008），狭窄长度也更低（19.715±5.225对比39.397±11.182；p = 0.007），对照支架的总长度与多支架植入的动脉段相似。组织学检查证实支架内狭窄的基础是肌内膜增生。
在猪模型中研究了多支架输送系统，证明了其可行性。临床前经验显示，在支架断裂、再狭窄以及股腘动脉局部支架植入的通畅性方面取得了良好结果。
