Che Haijie, Jiang Jingjun, Liu Hao, Wei Jichang, Zhang Xiaoming
1 Department of Vascular Surgery, Peking University Second School of Clinical Medicine, Peking University People's Hospital, Beijing, China.
2 Suzhou Yinluo Medical Devices Co., Ltd., Jiangsu, China.
Phlebology. 2019 May;34(4):246-256. doi: 10.1177/0268355518801172. Epub 2018 Sep 18.
Iliofemoral vein stenosis or occlusion is a common cause of severe chronic venous insufficiency. Endovascular venous stenting has become a preferred treatment because it is minimally invasive and has a high safety profile. Despite the wide application of the wallstent, it is not specifically designed for veins. There are currently few studies on braided stents in the field of veins. We designed a novel braided vein stent, which has higher radial resistive force and more optimized looped ends structure compared with the wallstent. The purpose of this study was to evaluate the safety and performance of the stent in animals, providing a reference for further clinical trials.
The Wallstent is used as a control group. The novel stent and the Wallstent were implanted in the iliac vein of sheep. After 30 days and 90 days, vascular injury, thrombus, neointima coverage, and luminal stenosis were evaluated through venous angiography, endoscopic observation of stent specimen and histopathology. Imaging, histology, and integration data were analyzed by t-test for comparisons between the groups.
Two groups of stents were successfully implanted. Follow-up observation showed that there was no thrombosis or obstruction >50% occurred in any group and no significant differences in patency, vascular injury, or intimal hyperplasia compared with the Wallstent.
The novel stent significantly increases the radial resistive force and does not increase vascular injury, thrombus and stent stenosis during 30-day and 90-day follow-up. The next step is to further validate the effectiveness of the stent through long-term animal observation and human clinical trials.
髂股静脉狭窄或闭塞是严重慢性静脉功能不全的常见原因。血管腔内静脉支架置入术已成为首选治疗方法,因为它微创且安全性高。尽管Wallstent广泛应用,但它并非专门为静脉设计。目前在静脉领域关于编织支架的研究较少。我们设计了一种新型编织静脉支架,与Wallstent相比,它具有更高的径向阻力和更优化的环形末端结构。本研究的目的是评估该支架在动物体内的安全性和性能,为进一步的临床试验提供参考。
将Wallstent作为对照组。将新型支架和Wallstent植入绵羊的髂静脉。30天和90天后,通过静脉血管造影、支架标本的内镜观察和组织病理学评估血管损伤、血栓、新生内膜覆盖和管腔狭窄情况。通过t检验分析成像、组织学和整合数据,以比较两组之间的差异。
两组支架均成功植入。随访观察表明,任何一组均未发生血栓形成或阻塞>50%,与Wallstent相比,在通畅性、血管损伤或内膜增生方面无显著差异。
新型支架显著增加了径向阻力,在30天和90天的随访期间未增加血管损伤、血栓形成和支架狭窄。下一步是通过长期动物观察和人体临床试验进一步验证该支架的有效性。