Document Detail


Stent and artery geometry determine intimal thickening independent of arterial injury.
MedLine Citation:
PMID:  10683357     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J M Garasic; E R Edelman; J C Squire; P Seifert; M S Williams; C Rogers
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  101     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-08     Completed Date:  2000-03-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  812-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine (Cardiac Catheterization Laboratory and Coronary Care Unit, Brigham and Women's Hospital), Harvard Medical School, Boston, MA 02115, USA. jmgarasic@bics.bwh.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Arteries / anatomy & histology*,  injuries,  pathology*
Cell Division
Equipment Design
Hyperplasia
Models, Cardiovascular
Rabbits
Stents* / adverse effects
Thrombosis / etiology
Tunica Intima / pathology*
Vasculitis / etiology
Wounds and Injuries / pathology
Grant Support
ID/Acronym/Agency:
GM/HL-49039/GM/NIGMS NIH HHS; HL-03104/HL/NHLBI NIH HHS; HL-60407/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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