Stent and artery geometry determine intimal thickening independent of arterial injury
Stent and artery geometry determine intimal thickening independent of arterial injury
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DOI：
10.1161/01.cir.101.7.812
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发表时间：
2000-02-22
期刊：
影响因子：
37.8
通讯作者：
Rogers, C
中科院分区：
文献类型：
--
作者：
Garasic, JM;Edelman, ER;Rogers, C
背景-临床试验表明，较大的即刻展开后支架直径提供了较大的最终管腔尺寸，而动物数据表明动脉损伤和支架设计决定了晚期新生内膜增厚。在展开时，支架拉伸血管，施加取决于支架设计的横截面多边形管腔形状，每个支柱用作顶点。我们问这种设计依赖的postdeployment管腔几何形状是否影响晚期新生内膜增厚独立的程度的支柱诱导injure.Methods和Results-Stainless钢支架3种不同的配置植入兔髂动脉3或28天。与每个横截面仅8个支柱的相同支架相比，每个横截面设计有12个支柱的支架的附壁血栓减少50%至60%，新生内膜面积减少2倍。单个支架的连续组织学切片显示，立即展开后管腔几何形状和随后的新生内膜面积沿每个支架亚单位的路线沿着变化。基于在初始支架施加的多边形管腔形状的范围内重建圆形血管管腔，支架施加在动脉上的形状的数学建模预测了晚期新生内膜面积。由支架设计决定，确定独立于动脉损伤的新生内膜厚度，并可用于预测新型支架设计的内膜生长模式。
Background-Clinical trials show that larger immediate postdeployment stent diameters provide greater ultimate luminal size, whereas animal data show that arterial injury and stent design determine late neointimal thickening. At deployment, a stent stretches a vessel, imposing a cross-sectional polygonal luminal shape that depends on the stent design, with each strut serving as a vertex. We asked whether this design-dependent postdeployment luminal geometry affects late neointimal thickening independently of the extent of strut-induced injury.Methods and Results-Stainless steel stents of 3 different configurations were implanted in rabbit iliac arteries for 3 or 28 days. Stents designed with 12 struts per cross section had 50% to 60% less mural thrombus and 2-fold less neointimal area than identical stents with only 8 struts per cross section. Sequential histological sectioning of individual stents showed that immediate postdeployment luminal geometry and subsequent neointimal area varied along the course of each stent subunit, Mathematical modeling of the shape imposed by the stent on the artery predicted late neointimal area, based on the re-creation of a circular vessel lumen within the confines of the initial stent-imposed polygonal luminal shape.Conclusions-Immediate postdeployment luminal geometry, dictated by stent design, determines neointimal thickness independently of arterial injury and may be useful for predicting patterns of intimal growth for novel stent designs.