Key Laboratory of Biorheological and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Modern Life Science Experiment Teaching Center, Bioengineering College of Chongqing University, Chongqing 400030, PR China.
State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China.
Acta Biomater. 2023 Aug;166:266-277. doi: 10.1016/j.actbio.2023.05.028. Epub 2023 May 19.
Atherosclerotic cardiovascular disease is a typical age-related disease accompanied by stiffening arteries. We aimed to elucidate the influence of aged arteries on in-stent restenosis (ISR) after the implantation of bioresorbable scaffolds (BRS). Histology and optical coherence tomography showed increased lumen loss and ISR in the aged abdominal aorta of Sprague-Dawley rats, with apparent scaffold degradation and deformation, which induce lower wall shear stress (WSS). This was also the case at the distal end of BRS, where the scaffolds degraded faster, and significant lumen loss was followed by a lower WSS. In addition, early thrombosis, inflammation, and delayed re-endothelialization were presented in the aged arteries. Degradation of BRS causes more senescent cells in the aged vasculature, increasing endothelial cell dysfunction and the risk of ISR. Thus, profoundly understanding the mechanism between BRS and senescent cells may give a meaningful guide for the age-related scaffold design. STATEMENT OF SIGNIFICANCE: The degradation of bioresorbable scaffolds aggravates senescent endothelial cells and a much lower wall shear stress areas in the aged vasculature, lead to intimal dysfunction and increasing in-stent restenosis risk. Early thrombosis and inflammation, as well as delayed re-endothelialization, are presented in the aged vasculature after bioresorbable scaffolds implantation. Age stratification during the clinical evaluation and senolytics in the design of new bioresorbable scaffolds should be considered, especially for old patients.
动脉粥样硬化性心血管疾病是一种典型的与年龄相关的疾病，伴有动脉僵硬。我们旨在阐明生物可吸收支架（BRS）植入后老年动脉对支架内再狭窄（ISR）的影响。组织学和光相干断层扫描显示，Sprague-Dawley 大鼠腹主动脉老化后管腔损失和 ISR 增加，支架明显降解和变形，导致壁面切应力（WSS）降低。在 BRS 的远端也是如此，支架降解更快，随后出现明显的管腔损失和较低的 WSS。此外，在老年动脉中还出现了早期血栓形成、炎症和延迟再内皮化。BRS 的降解导致老年血管中更多的衰老细胞，增加内皮细胞功能障碍和 ISR 的风险。因此，深入了解 BRS 和衰老细胞之间的机制可能为与年龄相关的支架设计提供有意义的指导。
生物可吸收支架的降解加剧了衰老的内皮细胞和老年血管中更低的壁面切应力区，导致内膜功能障碍和支架内再狭窄风险增加。生物可吸收支架植入后，老年血管中出现早期血栓形成和炎症，以及延迟再内皮化。在临床评估中进行年龄分层和在新的生物可吸收支架设计中使用衰老细胞抑制剂都应该被考虑，尤其是对于老年患者。
