In Vitro Quantification of Luminal Denudation After Crimping and Balloon Dilatation of Endothelialized Covered Stents
In Vitro Quantification of Luminal Denudation After Crimping and Balloon Dilatation of Endothelialized Covered Stents
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DOI：
10.1007/s00270-017-1661-x
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发表时间：
2017-05
影响因子：
2.9
通讯作者：
S. Ichihashi;Frederic Wolf;T. Schmitz-Rode;K. Kichikawa;S. Jockenhoevel;P. Mela
中科院分区：
文献类型：
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作者：
S. Ichihashi;Frederic Wolf;T. Schmitz-Rode;K. Kichikawa;S. Jockenhoevel;P. Mela
覆盖支架已被证明可以减少再狭窄；然而，膜有限的生物相容性仍可导致血栓形成。为了获得最佳的表面血液相容性，提出了管腔表面内皮化。然而，诸如卷曲和球囊扩张等分娩过程对内皮层的影响尚未被量化。本研究调查了这些程序对体外内皮化覆盖支架的影响。方法采用注射成型技术，用纤维蛋白覆盖裸金属支架，在动脉压（80-120 mmHg）和剪切应力（1 Pa）下进行内皮化，并在生物反应器中进行调节。每组实验准备三个覆盖支架，一个单独卷曲，一个卷曲后球囊扩张，另一个作为对照。这个实验重复了三次。通过扫描电镜（SEM）对内皮覆盖进行定量分析。应用免疫组织化学和扫描电镜观察富血小板血浆对内皮细胞功能的影响。结果对照组、卷曲支架、卷曲支架和球囊扩张支架的平均内皮覆盖率分别为87.6、80.1和52.1%，表明内皮细胞在卷曲支架后未发生明显分离（P= 0.465），而在球囊扩张支架后发生了明显分离（P< 0.001）。无论压接后还是压接后球囊扩张，支架表面的细胞均表达eNOS和CD31，且未表现出血小板粘附。结论模拟给药过程可使半数以上的腔面保留活细胞。主要损伤发生在球囊膨胀过程中。
PurposeCovered stents have been demonstrated to reduce restenosis; however, the membrane’s limited biocompatibility can still lead to thrombus formation. To obtain optimal surface hemocompatibility, endothelialization of the luminal surface has been proposed. However, the effect of delivery procedures, such as crimping and balloon dilatation, on the endothelial layer has not been quantified. This study investigated the impact of such procedures on endothelialized covered stents in vitro.MethodsUsing an injection molding technique, bare metal stents were covered with fibrin subsequently, endothelialized and conditioned in a bioreactor under arterial pressure (80–120 mmHg) and shear stress (1 Pa). For each set of experiments, three covered stents were prepared, one being subjected to crimping alone, one to crimping followed by balloon dilatation and one serving as control. The experiment was repeated three times. The endothelial coverage was quantified by scanning electron microscopy (SEM). The functionality of the endothelium after exposure to platelet-rich plasma was evaluated by immunohistochemistry and SEM.ResultsThe mean endothelial coverage of control, crimped, crimped and balloon-dilated stents was 87.6, 80.1 and 52.1%, respectively, indicating that endothelial cells detached significantly not after crimping (P= 0.465) but following balloon dilatation (P< 0.001). The cells present on the stent’s surface, either after crimping or crimping followed by balloon dilatation, expressed eNOS and CD31 and exhibited no platelet adhesion.ConclusionThe simulated delivery procedure resulted in the retention of viable cells on more than half of the luminal surface. The main damage to the layer occurred during balloon dilatation.