Li Yugang, Wang Lei, Chen Shanshan, Yu Dan, Sun Weifeng, Xin Shijie
Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China.
Institute of Metal Research, Chines Academy of Sciences, Shenyang, China.
Yonsei Med J. 2019 May;60(5):429-439. doi: 10.3349/ymj.2019.60.5.429.
To explore the effects of biodegradable magnesium alloy stents (BMAS) on remodeling of vein graft (VG) anastomotic restenosis.
To establish a VG restenosis model, seventy two New Zealand rabbits were randomly divided into three groups according to whether a stent was implanted in the graft vein or not. BMASs and 316L stainless steel stents were implanted in BMAS and 316L groups, respectively, while no stent was implanted in the no-treatment control group (NC group). Loss of lumen diameter in the graft vein was measured in all three groups. Upon harvesting VG segments to evaluate intimal proliferation and re-endothelization, the degradation and biological safety of the stents were observed to explore the effects of BMAS on VG remodeling.
Model establishment and stent implantation were successful. The BMAS reduced lumen loss, compared with the control group (0.05±0.34 mm vs. 0.90±0.39 mm, =0.001), in the early stage. The neointimal area was smaller in the BMAS group than the 316L group after 4 months (4.96±0.66 mm² vs. 6.80±0.69 mm², =0.017). Re-endothelialization in the BMAS group was better than that in the 316L group (=0.001). Within 4 months, the BMAS had degraded, and the magnesium was converted to phosphorus and calcium. The support force of the BMAS began to reduce at 2-3 months after implantation, without significant toxic effects.
BMAS promotes positive remodeling of VG anastomosis and has advantages over the conventional 316L stents in the treatment of venous diseases.
探讨可生物降解镁合金支架（BMAS）对静脉移植物（VG）吻合口再狭窄重塑的影响。
为建立VG再狭窄模型，72只新西兰兔根据移植物静脉是否植入支架随机分为三组。BMAS组和316L组分别植入BMAS和316L不锈钢支架，而未治疗对照组（NC组）未植入支架。测量三组移植物静脉的管腔直径损失。在收获VG节段以评估内膜增殖和再内皮化时，观察支架的降解情况和生物安全性，以探讨BMAS对VG重塑的影响。
模型建立和支架植入成功。早期，与对照组相比，BMAS减少了管腔损失（0.05±0.34mm对0.90±0.39mm，P=0.001）。4个月后，BMAS组的新生内膜面积小于316L组（4.96±0.66mm²对6.80±0.69mm²，P=0.017）。BMAS组的再内皮化优于316L组（P=0.001）。4个月内，BMAS发生降解，镁转化为磷和钙。BMAS的支撑力在植入后2 - 3个月开始降低，且无明显毒性作用。
BMAS促进VG吻合口的正向重塑，在治疗静脉疾病方面比传统的316L支架具有优势。
