Preclinical Evaluation of the Thrombogenicity and Endothelialization of Bare Metal and Surface-Coated Neurovascular Stents
Preclinical Evaluation of the Thrombogenicity and Endothelialization of Bare Metal and Surface-Coated Neurovascular Stents
复制标题
DOI：
10.3174/ajnr.a4109
复制
发表时间：
2015-01-01
影响因子：
3.5
通讯作者：
Wendel, H. P.
中科院分区：
文献类型：
--
作者：
Krajewski, S.;Neumann, B.;Wendel, H. P.
背景和目的：支架辅助弹簧圈栓塞术通常用于复杂或宽颈颅内动脉瘤的血管内治疗。然而，支架内血栓形成、血栓栓塞事件和缺血性并发症仍然是与支架植入物相关的主要问题。因此，我们研究了一种新型的金属裸表面的低剖面神经血管支架的血栓形成和内皮化，并与涂有白蛋白或肝素的相同支架进行了比较。材料和方法：将裸金属和肝素或白蛋白涂层支架装载在肝素涂层管中，然后用肝素化的人血（n = 5）填充，并以150 mL/min和37 ℃循环60分钟。在循环前和循环后，进行各种炎症和凝血标志物的测量和扫描电镜检查。在体外模型，包括人脐血管内皮cells.RESULTS：我们的研究结果表明，血小板丢失和血小板活化和激活的凝血级联反应，这是由裸金属支架，肝素或白蛋白涂层显着减少支架的内皮化。裸金属或涂层支架未诱导对红细胞、白细胞和补体级联反应的不良反应。此外，裸金属和白蛋白涂层支架表现出良好的内皮化properties.CONCLUSIONS：白蛋白和肝素涂层明显改善血栓形成的支架，从而可能代表在颅内动脉瘤的治疗的根本进展。此外，在生理条件下对神经血管支架的临床前评价支持并加速了生物相容性更好的神经血管支架的开发。
BACKGROUND AND PURPOSE: Stent-assisted coiling is routinely used for the endovascular treatment of complex or wide-neck intracranial aneurysms. However, in-stent thrombosis, thromboembolic events, and ischemic complications remain a major concern associated with stent implants. Therefore, a novel low-profile neurovascular stent with a bare metal surface was investigated with regard to thrombogenicity and endothelialization and compared with the same stent coated with albumin or heparin.MATERIALS AND METHODS: The bare metal and heparin- or albumin-coated stents were loaded in heparin-coated tubing, which was then filled with heparinized human blood (n = 5) and circulated at 150 mL/min and 37 degrees C for 60 minutes. Before and after circulation, measurement of various inflammation and coagulation markers and scanning electron microscopy were performed. Endothelialization of the stents was investigated in an in vitro model including human umbilical vascular endothelial cells.RESULTS: Our results showed that platelet loss and platelet activation and activation of the coagulation cascade, which are induced by the bare metal stents, were significantly reduced by heparin or albumin coating. Adverse effects on erythrocytes, leukocytes, and the complement cascade were not induced by the bare metal or coated stents. Moreover, the bare metal and albumin-coated stents showed good endothelialization properties.CONCLUSIONS: Albumin and heparin coatings clearly improve the thrombogenicity of the stents and thus may represent fundamental progress in the treatment of intracranial aneurysms. Moreover, preclinical evaluation of neurovascular stents under physiologic conditions supports and accelerates the development of more biocompatible neurovascular stents.