Stefanadis C, Toutouzas K, Vlachopoulos C, Stratos C, Kallikazaros I, Karayannakos P, Gravanis M M, Robinson K, Toutouzas P
Department of Cardiology, Hippokration Hospital, University of Athens, Greece.
J Am Coll Cardiol. 1996 Oct;28(4):1039-46. doi: 10.1016/s0735-1097(96)00267-7.
A new type of coated stent, consisting of a conventional stent covered by an autologous vein graft, was developed at our institution.
Coated stents are under investigation to address stenting limitations. However, experimental implantation of coated stents covered by autologous tissue has not been reported.
An autologous vein graft was removed and carefully prepared. Subsequently, a Palmaz stent was covered by the vein graft both internally and externally. Twenty-seven stents were implanted in the normal iliac arteries of 27 pigs weighing 18 to 33 kg. In 15 of the pigs, 15 noncoated Palmaz stents were implanted in the contralateral artery; these animals served as the control group. The animals were followed up angiographically for a period ranging from 7 days to 6 months. At the time of death, the stented segments were removed, and histomorphometric analysis was performed.
Autologous vein graft-coated stent preparation and implantation was feasible and uncomplicated. In both stents, angiographic follow-up revealed the absence of thrombosis, except for two cases of subacute thrombosis in the control group. The thickness of the intimal layer was greater in the coated stents and seems to be due to the existence of the internal vein layer ([mean +/- SD] 0.57 +/- 0.12 vs. 0.27 +/- 0.13 mm, p = 0.001). The arterial media of the coated stent segments was thinner than that in the control group (0.14 +/- 0.03 vs. 0.18 +/- 0.01 mm, p = 0.02).
The autologous vein graft-coated stent seems to be nonthrombogenic, and only minimal hyperplasia was observed in the pigs. Further studies are needed to explore the efficacy of this technique in humans.
我们机构研发了一种新型涂层支架，它由覆盖有自体静脉移植物的传统支架组成。
涂层支架正在研究中，以解决支架置入的局限性。然而，自体组织覆盖的涂层支架的实验性植入尚未见报道。
取出一条自体静脉移植物并仔细制备。随后，将Palmaz支架内外均覆盖静脉移植物。将27个支架植入27只体重18至33千克猪的正常髂动脉中。在15只猪的对侧动脉中植入15个未涂层的Palmaz支架；这些动物作为对照组。对动物进行血管造影随访7天至6个月。在处死时，取出植入支架的节段并进行组织形态计量分析。
自体静脉移植物涂层支架的制备和植入是可行且不复杂的。在两种支架中，血管造影随访显示均无血栓形成，但对照组有2例亚急性血栓形成。涂层支架内膜层厚度更大，似乎是由于内部静脉层的存在（[均值±标准差]0.57±0.12对0.27±0.13毫米，p = 0.001）。涂层支架节段的动脉中膜比对照组薄（0.14±0.03对0.18±0.01毫米，p = 0.02）。
自体静脉移植物涂层支架似乎不具有血栓形成性，在猪中仅观察到极少的增生。需要进一步研究以探索该技术在人体中的疗效。
