Document Detail


Long term impact of balloon post-dilatation on neointimal formation: an experimental comparative study between 2(nd) generation self-expanding versus balloon-expandable stent technologies.
MedLine Citation:
PMID:  22511520     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Self-expanding stents (SES) are reemerging as therapeutic alternatives to treat coronary artery disease. It has been proposed that SES can improve clinical outcomes by inducing less injury at implantation and achieving better vessel wall apposition. To date, little data exists comparing the vascular response to both methods of deployment in a controlled experimental setting. OBJECTIVE: To quantify differences in vascular injury and healing between second-generation SES and balloon-expandable stents (BES) and the effects of balloon post-dilation in a porcine coronary model. METHODS: 75 bare SES (AXXESS or vProtect) and 42 BES (Vision) were implanted in porcine coronaries. A subset of these received balloon post-dilation (SES+D=22, BES+D=20). Follow-up was scheduled at 30 (BES=10, BES+D=6, SES=19, SES+D=8), 90 (BES=6, BES+D=8, SES=19, SES+D=8) and 180 days (BES=6, BES+D=6, SES=15, SES+D=6). RESULTS: In vivo imaging and histological analysis showed that neointimal formation peaks early (30 days) in BES. Conversely, for SES, the peak occurred later (90 days). However, the neointimal formation achieved in either group equalized at 180 days. For SES, post-dilation shortened the peak of neointimal formation to 30 days. Conversely, for BES, post-dilation delayed the peak of neointimal formation to 90 days. At 30 days, histology showed that SES had significantly less injury. However, at 90 days, injury scores tended to be higher for SES. By 180 days, injury scores were comparable between both groups. CONCLUSIONS: The mechanism of stent expansion influences the degree of vascular injury and healing. The synergistic use of balloon post-dilation changes the dynamics of healing and may impact the potential beneficial effects inherent to SES technologies. © 2012 Wiley Periodicals, Inc.
Authors:
Michael S Aboodi; Krzysztof Milewski; Armando Tellez; Yanping Cheng; Geng-Hua Yi; Greg L Kaluza; Juan F Granada
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-18
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Skirball Center for Cardiovascular Research, Cardiovascular Research Foundation, Orangeburg, NY, US.
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