ENDOVASCULAR STENT DESIGN DICTATES EXPERIMENTAL RESTENOSIS AND THROMBOSIS
ENDOVASCULAR STENT DESIGN DICTATES EXPERIMENTAL RESTENOSIS AND THROMBOSIS
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DOI：
10.1161/01.cir.91.12.2995
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发表时间：
1995-06-15
期刊：
影响因子：
37.8
通讯作者：
EDELMAN, ER
中科院分区：
文献类型：
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作者：
ROGERS, C;EDELMAN, ER
背景：血管介入术使初始管腔直径最大化，可引起广泛的新生内膜增生，但其影响最小化，导致长期管腔尺寸更大。然而，诸如血管内支架之类的介入手术使管腔尺寸增加到球囊血管成形术所实现的管腔尺寸以上，因此易发生频繁的血栓形成和再狭窄。目前还不清楚是否对支架引起的损伤的反应是完全由支架引起的动脉扩张的程度或支架的几何构型或与血管壁接触的材料是否也contribute.Methods和结果我们研究了血管反应钢支架部署在裸露的兔髂动脉14天。在一组实验中，检查支架配置的影响，保持直径、质量、表面积和支架表面材料恒定。在另一组中，支架表面材料发生变化，但质量、构型和直径不变。在不影响质量或表面积的情况下，改变支架配置以减少29%的支柱-支柱交叉点，使血管损伤减少42%，血栓形成减少69%，新生内膜增生减少38%。单核细胞粘附支架动脉与血管损伤和新生内膜增生呈线性相关（r= 0.96，P
Background Vascular interventions that maximize initial lumen diameter provoke extensive neointimal hyperplasia but minimize its effects, causing long-term lumen size to be greater. Nevertheless, interventions such as endovascular stents, which increase lumen size above that achieved with balloon angioplasty, are subject to frequent thrombosis and restenosis. It has been unclear whether the response to stent-induced injury is determined solely by the degree of stent-induced arterial expansion or whether the geometric configuration of the stent or the material left in contact with the vessel wall also contribute.Methods and Results We examined the vascular response to steel stents deployed in denuded rabbit iliac arteries for 14 days. In one set of experiments, the effects of stent configuration were examined, holding diameter, mass, surface area, and stent surface material constant. In another set, stent surface material was changed, with mass, configuration, and diameter unaltered. Changing stent configuration to reduce strut-strut intersections by 29% without affecting mass or surface area reduced vascular injury by 42%, thrombosis by 69%, and neointimal hyperplasia by 38%. Monocyte adhesion to stented arteries correlated linearly with vascular trauma and neointimal hyperplasia (r=.96, P