Subacute thrombosis and vascular injury resulting from slotted-tube nitinol and stainless steel stents in a rabbit carotid artery model.
Subacute thrombosis and vascular injury resulting from slotted-tube nitinol and stainless steel stents in a rabbit carotid artery model.
复制标题
兔颈动脉模型中开槽管镍钛合金和不锈钢支架引起的亚急性血栓形成和血管损伤。
DOI：
10.1161/01.cir.94.7.1733
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发表时间：
1996
期刊：
影响因子：
37.8
通讯作者：
Eigler,N
中科院分区：
文献类型：
--
作者：
Sheth,S;Litvack,F;Dev,V;Fishbein,MC;Forrester,JS;Eigler,N
背景我们的目的是量化兔颈动脉模型中开槽管几何形状不锈钢和镍钛合金冠状动脉支架的血栓形成性和血管损伤程度。方法和结果将支架植入兔右颈动脉，无需抗血小板治疗。不锈钢支架植入4天，而镍钛合金支架植入4天和14天（n分别=8、8和6）。通过血栓重量、血栓侵入管腔的分级以及支架内动脉和对侧动脉的血流量来评估支架内血栓形成。第 4 天的不锈钢支架比第 4 天和第 14 天的镍钛合金支架含有更多的血栓（分别为 20.0±5.9 毫克、2.5±0.6 毫克和 2.7±0.3 毫克；P<.000001）。与镍钛诺支架（14 例中的 0 例，P<.002）相比，不锈钢支架更常被血栓闭塞（8 例中的 6 例）或包含更多的闭塞血栓（8 例中的 2 例）。与使用 4 天和 14 天的镍钛诺支架相比，使用不锈钢支架的动脉静息血流量减少（分别为 1.5±2.8 vs 24.0±2.0 和 25.5±1.9 mL/min，P<.000001）。不锈钢支架扩张不太均匀，对血管壁的支柱穿透更深，并且与更广泛的内侧平滑肌细胞坏死有关。血栓形成程度（血栓重量和等级）的变量与组织学确定的血管损伤（支柱穿透和内侧坏死）之间存在很强的相关性（r=.77 至 .95）。 结论 在兔颈动脉模型中，开槽管不锈钢支架比镍钛诺支架更容易形成血栓，并造成更广泛的血管损伤。这些差异背后的机制可能与两种支架类型的冶金和设计几何特性有关。
BackgroundOur objectives were to quantify the thrombogenicity and extent of vascular injury created by slotted-tube geometry stainless steel and nitinol coronary stents in a rabbit carotid artery model.Methods and ResultsStents were implanted in rabbit right carotid arteries without antiplatelet therapy. Stainless steel stents were implanted for 4 days while nitinol stents were placed for 4 and 14 days (n=8, 8, and 6, respectively). Stent thrombosis was assessed by thrombus weight, grading thrombus encroachment of the lumen, and by blood flow in the stented and contralateral arteries. Stainless steel stents at 4 days contained more thrombus than 4- and 14-day nitinol stents (20.0±5.9 versus 2.5±0.6 and 2.7±0.3 mg, respectively;P<.000001). Stainless steel stents were more often occluded by thrombus (6 of 8) or contained more subocclusive thrombus (2 of 8) than nitinol stents (0 of 14,P<.002). Resting blood flow was reduced in arteries with stainless steel stents compared with 4- and 14-day nitinol stents (1.5±2.8 versus 24.0±2.0 and 25.5±1.9 mL/min, respectively,P<.000001). Stainless steel stents were less uniformly expanded, had deeper strut penetration into the vascular wall, and were associated with more extensive medial smooth muscle cell necrosis. There were strong correlations (r=.77 to .95) between variables of thrombosis extent (thrombus weight and grade) and histologically determined vascular injury (strut penetration and medial necrosis).ConclusionsSlotted-tube stainless steel stents were more thrombogenic and created more extensive vascular injury than nitinol stents in a rabbit carotid artery model. The mechanisms underlying these differences probably are related to metallurgic and design geometry properties of the two stent types.