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不锈钢和钽冠状动脉支架的血栓形成性比较。

Comparison of the thrombogenicity of stainless steel and tantalum coronary stents.

作者信息

Scott N A, Robinson K A, Nunes G L, Thomas C N, Viel K, King S B, Harker L A, Rowland S M, Juman I, Cipolla G D

机构信息

Andreas Gruentzig Cardiovascular Center, Emory University Hospital, Atlanta, GA 30322, USA.

出版信息

Am Heart J. 1995 May;129(5):866-72. doi: 10.1016/0002-8703(95)90105-1.

Abstract

This study was designed to compare the thrombogenicity of stainless steel and tantalum coronary stents of the same design. Stainless steel and tantalum coronary stents are being evaluated for their utility in treating acute closure and restenosis. A major disadvantage of stainless steel stents is radiolucency. To determine whether radioopaque tantalum stents may be safely substituted for stainless steel stents, we compared the relative thrombogenicity of these materials in stents of identical design. Total platelet and fibrin deposition on the stents were determined from measurements of indium 111-labeled platelet and iodine 125-labeled fibrinogen accumulation after deployment into exteriorized chronic arteriovenous shunts in seven untreated baboons. In another series of experiments, 111In-platelet deposition was compared 2 hours after stent implantation in coronary arteries of pigs. In baboons, platelet thrombus formation on stainless steel and tantalum stents was equivalent and plateaued at approximately 2.5 x 10(9) platelets after 1 hour (p > 0.05). Fibrin deposition averaged approximately 1 mg/stent and did not differ between the stainless steel and tantalum stents (p > 0.05). In the porcine coronary model there was no significant difference in 111In-labeled platelet deposition between the stainless steel and tantalum stents (p > 0.05). This result was confirmed by scanning electron microscopic analysis of the coronary stents. Based on these two models, we conclude that there is no significant difference in the thrombogenicity of stainless steel and tantalum wire coil stents.

摘要

本研究旨在比较相同设计的不锈钢和钽冠状动脉支架的血栓形成倾向。不锈钢和钽冠状动脉支架正在接受治疗急性闭塞和再狭窄效用方面的评估。不锈钢支架的一个主要缺点是射线可透性。为了确定不透射线的钽支架是否可以安全地替代不锈钢支架,我们比较了这些材料在相同设计支架中的相对血栓形成倾向。通过测量铟111标记的血小板和碘125标记的纤维蛋白原在植入7只未经治疗的狒狒的体外慢性动静脉分流后在支架上的蓄积,来测定支架上总的血小板和纤维蛋白沉积。在另一系列实验中,比较了猪冠状动脉内植入支架2小时后铟111标记的血小板沉积情况。在狒狒中,不锈钢和钽支架上的血小板血栓形成情况相当,1小时后血小板数量稳定在约2.5×10⁹个(p>0.05)。纤维蛋白沉积平均约为1mg/支架,不锈钢和钽支架之间无差异(p>0.05)。在猪冠状动脉模型中,不锈钢和钽支架之间铟111标记的血小板沉积无显著差异(p>0.05)。冠状动脉支架的扫描电子显微镜分析证实了这一结果。基于这两个模型,我们得出结论,不锈钢和钽丝线圈支架的血栓形成倾向无显著差异。

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