Singh Prabh G, Kilari Sreenivasulu, Misra Sanjay
Vascular and Interventional Radiology Translational Research Lab, Rochester, Minnesota.
Vascular and Interventional Radiology Translational Research Lab, Rochester, Minnesota; Department of Radiology, Mayo Clinic, Rochester, Minnesota.
J Vasc Interv Radiol. 2025 Apr;36(4):660-669.e3. doi: 10.1016/j.jvir.2024.12.023. Epub 2024 Dec 24.
To describe the immunohistologic changes in arteriovenous fistula stenosis treated using plain old balloon angioplasty (POBA) versus paclitaxel drug-coated balloons (DCBs).
Castrated male Yorkshire pigs (n = 12) 4-5 months old had chronic kidney disease induced with renal artery embolization. Twenty-eight days later, a side-to-end anastomosis was created between the left common carotid artery and ipsilateral external jugular vein. Four weeks later, a juxta-anastomotic stenosis was treated with balloon angioplasty (percutaneous transluminal angioplasty [PTA]) or DCB, and animals were euthanized at 4 (POBA [n = 6]) and 42 days (POBA [n = 3] or DCB [n = 3]) for histomorphometric analysis with immunohistochemical staining for CD68 (macrophages), FSP-1 (fibroblasts), α-smooth muscle cell (SMC) actin, CD-31 (endothelial), proliferation (Ki-67), and apoptosis (terminal deoxynucleotidyl transferase dUTP nick end labeling [TUNEL]).
Two animals died at 14 and 28 days after PTA. There was a significant increase in the lumen (P = .0431), neointima (P = .0156 at Day (D) 4 and P < .001 at D42), and neointima/media + adventitia (N/M + A) ratio (P = .0061 at D4 and P = .0032 at D42). DCB-treated vessels showed a significant decrease in the N/M + A ratio (P = .0386) and cell density in the intima (P = .0113) compared with those treated with POBA. Endothelial cells were significantly increased at 4 days (P = .0034) and 42 days (P = .012), macrophages were significantly increased at 14 days (P = .0094), fibroblasts were significantly increased at 4 days (P = .0025) and 42 days (P < .001), and SMCs were significantly increased at 28 days (P = .004). Ki-67 staining peaked at 28 days (P = .0018), and TUNEL staining decreased at 4 days (P = .0012), 14 days (P = .0062), and 42 days (P = .04).
After PTA, the lumen vessel area increases with fibroblast and SMCs peaking at 4, followed by macrophages, SMCs, and proliferation.
描述使用普通球囊血管成形术（POBA）与紫杉醇药物涂层球囊（DCB）治疗动静脉内瘘狭窄后的免疫组织学变化。
对4 - 5月龄的去势雄性约克夏猪（n = 12）进行肾动脉栓塞诱导慢性肾病。28天后，在左颈总动脉和同侧颈外静脉之间进行端侧吻合。4周后，对吻合口附近的狭窄进行球囊血管成形术（经皮腔内血管成形术[PTA]）或DCB治疗，分别在4天（POBA [n = 6]）和42天（POBA [n = 3]或DCB [n = 3]）对动物实施安乐死，进行组织形态计量分析，并对CD68（巨噬细胞）、FSP - 1（成纤维细胞）、α - 平滑肌细胞（SMC）肌动蛋白、CD - 31（内皮细胞）、增殖（Ki - 67）和凋亡（末端脱氧核苷酸转移酶dUTP缺口末端标记[TUNEL]）进行免疫组织化学染色。
2只动物在PTA后14天和28天死亡。管腔（P = .0431）、新生内膜（第4天P = .0156，第42天P < .001）以及新生内膜/中膜 + 外膜（N/M + A）比值（第4天P = .0061，第42天P = .0032）均显著增加。与POBA治疗的血管相比，DCB治疗的血管N/M + A比值（P = .0386）和内膜细胞密度（P = .0113）显著降低。内皮细胞在4天（P = .0034）和42天（P = .012）显著增加，巨噬细胞在14天（P = .0094）显著增加，成纤维细胞在4天（P = .0025）和42天（P < .001）显著增加，SMC在28天（P = .004）显著增加。Ki - 67染色在28天达到峰值（P = .0018），TUNEL染色在4天（P = .0012）、14天（P = .0062）和42天（P = .04）降低。
PTA后，管腔血管面积增加，成纤维细胞和SMC在4天时达到峰值，随后是巨噬细胞、SMC和增殖。
