Document Detail

Compliance matching stent placement in the carotid artery of the swine promotes optimal blood flow and attenuates restenosis.
MedLine Citation:
PMID:  15350569     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We assessed the value of a gradient-compliant stent in an animal model. METHODS: Bilateral carotid arteries were stented with nitinol stents having variable-oversizing, variable-stiffness, and with (CMS, 10 animals) and without (SMART, four animals) compliance-matching endings. Angiography, hemodynamic, scanning-electron-microscopic and histological analyses were performed at 3-month. The protocol was completed in 14 among 19 swines. RESULTS: Transient (1-month) exaggerated recoil, attributable to stress-induced phasic inhibition of vasorelaxation, developed at CMS endings. At mid-term, all stents were endothelialized; CMS-stents, but not SMART-stents, were incorporated into walls (one-strut-thickness). Restenosis developed outside SMART-stents (cell migration+wall-compensatory enlargement) whereas CMS-stents elicited no or focalized cell-accumulations at endings that bulged vascular walls radially outward. SMART-stents were blood-flow neutral, whereas CMS-stents favored (higher-stiffness, higher-oversizing) or opposed (lower-stiffness, less-oversizing) carotid blood flow. CONCLUSIONS: Direct carotid stenting with stents having compliance-matched endings and specific requirements of stiffness and oversizing can optimize blood flow to the brain and restrict local restenosis.
P H Rolland; C Mekkaoui; V Vidal; J L Berry; J E Moore; M Moreno; P Amabile; J M Bartoli
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  28     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-07     Completed Date:  2004-11-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  431-8     Citation Subset:  IM    
Laboratory of Hemodynamics and Cardiovascular Mechanics, School of Medicine, Marseille, France.
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MeSH Terms
Blood Pressure / physiology
Blood Vessel Prosthesis Implantation
Carotid Artery, Common / physiopathology*,  radiography,  surgery*
Endothelium, Vascular / physiopathology,  radiography
Follow-Up Studies
Graft Occlusion, Vascular / etiology*,  physiopathology*,  radiography
Models, Animal
Models, Cardiovascular
Pulsatile Flow
Regional Blood Flow / physiology
Statistics as Topic
Time Factors
Tunica Intima / physiopathology,  radiography
Venous Thrombosis / etiology,  physiopathology,  radiography

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