Document Detail


A porcine coronary stent model of increased neointima formation in the left anterior descending coronary artery.
MedLine Citation:
PMID:  12426824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinical trials suggest an increased frequency of restenosis after coronary intervention in left anterior descending (LAD) compared to the left circumflex or right coronary arteries. Experimental studies correlate stent-induced arterial injury and the extent of neointima formation. This study investigates whether the coronary artery affects the relationship between arterial injury and neointima hyperplasia in the porcine stent model. METHODS: Non-lipemic farm pigs underwent stent placement in the LAD (n = 26) and the right coronary artery (RCA; n = 30). Quantitative coronary angiography (QCA) was performed before and after stent placement, and at follow-up; quantitative histomorphometry and injury score were analyzed at 30-day follow-up. RESULTS: Initial procedure balloon/artery ratios (LAD 1.17 +/- 0.11 vs RCA 1.17 +/- 0.09, P = NS), and minimal stent lumen diameters (MLD; LAD 2.91 +/- 0.31 vs RCA: 2.93 +/- 0.28 mm, P = NS) were similar suggesting no difference in deployment technique. At follow-up there was more restenosis in the LAD (diameter stenosis: 55.0 +/- 26.4% vs 37.3 +/- 18.1%, and MLD: 1.24 +/- 0.78 mm vs. 1.71 +/- 0.57 mm, P < 0.05 for both comparisons). No differences were seen for injury score (1.09 +/- 0.51 vs 1.01 +/- 0.57; LAD vs RCA) or stent area (6.13 +/- 0.99 vs 6.55 +/- 1.42 mm2). Histomorphometry demonstrated smaller lumen area (2.15 +/- 0.94 vs 2.96 +/- 1.29 mm2) and thicker neointima (0.63 +/- 0.25 vs 0.51 +/- 0.17 mm; all P < 0.05) in the LAD. Multiple linear regression analysis identified the LAD as an independent predictive factor for increased neointima formation. CONCLUSIONS: These observations establish an animal model that is consistent with clinical experience showing that restenosis after stenting is more common in the LAD. The findings may be useful for understanding and developing systemic and local antirestenotic strategies.
Authors:
J Hausleiter; M Sebastian; A N Li; C K Abbey; H Honda; R Makkar; J S Whiting; N Eigler
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Zeitschrift für Kardiologie     Volume:  91     ISSN:  0300-5860     ISO Abbreviation:  Z Kardiol     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-11-12     Completed Date:  2003-02-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0360430     Medline TA:  Z Kardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  614-9     Citation Subset:  IM    
Affiliation:
Deutsches Herzzentrum München Lazarettstrasse 36 80636 München, Germany. hausleiter@dhm.mhn.de
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation*
Animals
Coronary Angiography
Coronary Restenosis / pathology*,  radiography
Coronary Vessels / injuries*,  pathology
Disease Models, Animal
Fibromuscular Dysplasia / pathology,  radiography
Image Processing, Computer-Assisted
Linear Models
Stents*
Swine
Tunica Intima / injuries*,  pathology

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


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