Nickel-free stainless steel avoids neointima formation following coronary stent implantation
Nickel-free stainless steel avoids neointima formation following coronary stent implantation
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DOI：
10.1088/1468-6996/13/6/064218
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发表时间：
2012-12-01
影响因子：
5.5
通讯作者：
Nagai, Ryozo
中科院分区：
文献类型：
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作者：
Fujiu, Katsuhito;Manabe, Ichiro;Nagai, Ryozo
SUS316L不锈钢、钴铬合金和铂铬合金是冠状动脉支架广泛使用的平台。这些合金还含有镍（Ni），据报道，镍在某些受试者中会引起过敏反应，并且已知对细胞有各种影响。然而，镍对支架植入后新内膜形成的影响尚不清楚。我们开发了用氮气加压电渣重熔（P-ESR）工艺制备的无ni高氮奥氏体不锈钢制成的冠状动脉支架。然后比较无镍和SUS316L不锈钢支架在猪冠状动脉内支架植入后的内膜形成和炎症反应。我们发现，与SUS316L支架相比，植入无镍支架的动脉内膜形成和炎症明显减少。值得注意的是，Ni2+从SUS316L中被洗脱到培养基中，而没有从无ni的不锈钢中被洗脱到培养基中。机制上，Ni2+增加了培养平滑肌细胞中缺氧诱导因子蛋白-1 α (HIF-1 α)及其靶基因的水平。HIF-1 α及其靶基因水平在SUS316L支架部位的血管壁中也升高，而在无镍支架部位则没有升高。无镍不锈钢冠状动脉支架减少新内膜形成，部分原因是通过Ni-HIF途径避免炎症过程的激活。无镍不锈钢支架是一种很有前途的新型冠状动脉支架平台。
SUS316L stainless steel and cobalt-chromium and platinum-chromium alloys are widely used platforms for coronary stents. These alloys also contain nickel (Ni), which reportedly induces allergic reactions in some subjects and is known to have various cellular effects. The effects of Ni on neointima formation after stent implantation remain unknown, however. We developed coronary stents made of Ni-free high-nitrogen austenitic stainless steel prepared using a N-2-gas pressurized electroslag remelting (P-ESR) process. Neointima formation and inflammatory responses following stent implantation in porcine coronary arteries were then compared between the Ni-free and SUS316L stainless steel stents. We found significantly less neointima formation and inflammation in arteries implanted with Ni-free stents, as compared to SUS316L stents. Notably, Ni2+ was eluted into the medium from SUS316L but not from Ni-free stainless steel. Mechanistically, Ni2+ increased levels of hypoxia inducible factor protein-1 alpha (HIF-1 alpha) and its target genes in cultured smooth muscle cells. HIF-1 alpha and their target gene levels were also increased in the vascular wall at SUS316L stent sites but not at Ni-free stent sites. The Ni-free stainless steel coronary stent reduces neointima formation, in part by avoiding activation of inflammatory processes via the Ni-HIF pathway. The Ni-free-stainless steel stent is a promising new coronary stent platform.