Biological coating for arterial stents: The next evolutionary change in stents

Kevin Carnevale, Kenneth Ouriel, Yves Gabriel, Daniel Clair, James F. Bena, Michael Silva, Timur P. Sarac

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: To describe the in vivo results of a promising new stent-graft lined with peritoneum. Methods: Eighteen dogs underwent balloon angioplasty injury to the bilateral iliac arteries followed by placement of either an 8-mm × 5-cm glutaraldehyde-fixed bovine peritoneum-lined balloon-expandable stent (PLS) or a similarly sized, commercially prepared, polyester-lined self-expanding stent (DLS) as a control. Animals were sacrificed at 1 and 6 months. Biplanar arteriography and intravascular ultrasound were done at the time of sacrifice, and the vessels were harvested after perfusion fixation for histology/morphometry. Immunofluorescence with CD34 and factor VIII staining was used to evaluate endothelialization, while α-actin was used to quantify smooth muscle cell (SMC) deposition. Results: At 1 month, all vessels were patent in both groups. At 6 months, 8 of 9 vessels were open in the PLS group versus 6 of 9 in the control DLS group. Vessel lumen diameter at 1 month was significantly greater in the PLS vessels compared to the DLS group at 1 cm above the stent (35.9±4.4 versus 29.4±4.7 mm2; p=0.02) and 1 cm below the stent (37.2±7.1 versus 25.2±3.2 mm2; p=0.005); these results persisted to 6 months. Histological morphometry demonstrated progression of neointimal hyperplasia in the DLS stent between 30 and 180 days (8.3±1.79 versus 14.9±6.6 mm2; p=0.03), whereas the peritoneum-lined stent had no change during the same time period (4.62±0.98 versus 4.72±0.97 mm2; p=0.85). The same patterns were true for the intima:media ratio. Immunohistochemistry demonstrated complete endothelialization at 6 months in both DLS and PLS. However, SMC staining with α-actin demonstrated more smooth muscle actin-positive cells in the DLS compared to the PLS (327±87 versus 262±73 counts/5 high-powered fields; p=0.04). Conclusion: Peritoneum-lined stents offer a novel method to improve patency of lower extremity arterial stents.

Original languageEnglish (US)
Pages (from-to)164-174
Number of pages11
JournalJournal of Endovascular Therapy
Volume13
Issue number2
DOIs
StatePublished - Apr 2006
Externally publishedYes

Fingerprint

Stents
Peritoneum
Actins
Smooth Muscle Myocytes
Staining and Labeling
Polyesters
Balloon Angioplasty
Iliac Artery
Factor VIII
Glutaral
Hyperplasia
Fluorescent Antibody Technique
Smooth Muscle
Lower Extremity
Histology
Angiography
Perfusion
Immunohistochemistry
Dogs
Transplants

Keywords

  • Balloon injury model
  • Canine model
  • Neointimal hyperplasia
  • Peritoneum
  • Restenosis
  • Stent-graft

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Carnevale, K., Ouriel, K., Gabriel, Y., Clair, D., Bena, J. F., Silva, M., & Sarac, T. P. (2006). Biological coating for arterial stents: The next evolutionary change in stents. Journal of Endovascular Therapy, 13(2), 164-174. https://doi.org/10.1583/05-1710R.1

Biological coating for arterial stents : The next evolutionary change in stents. / Carnevale, Kevin; Ouriel, Kenneth; Gabriel, Yves; Clair, Daniel; Bena, James F.; Silva, Michael; Sarac, Timur P.

In: Journal of Endovascular Therapy, Vol. 13, No. 2, 04.2006, p. 164-174.

Research output: Contribution to journalArticle

Carnevale, K, Ouriel, K, Gabriel, Y, Clair, D, Bena, JF, Silva, M & Sarac, TP 2006, 'Biological coating for arterial stents: The next evolutionary change in stents', Journal of Endovascular Therapy, vol. 13, no. 2, pp. 164-174. https://doi.org/10.1583/05-1710R.1
Carnevale, Kevin ; Ouriel, Kenneth ; Gabriel, Yves ; Clair, Daniel ; Bena, James F. ; Silva, Michael ; Sarac, Timur P. / Biological coating for arterial stents : The next evolutionary change in stents. In: Journal of Endovascular Therapy. 2006 ; Vol. 13, No. 2. pp. 164-174.
@article{b781baf619594367b3728ce1cafac368,
title = "Biological coating for arterial stents: The next evolutionary change in stents",
abstract = "Purpose: To describe the in vivo results of a promising new stent-graft lined with peritoneum. Methods: Eighteen dogs underwent balloon angioplasty injury to the bilateral iliac arteries followed by placement of either an 8-mm × 5-cm glutaraldehyde-fixed bovine peritoneum-lined balloon-expandable stent (PLS) or a similarly sized, commercially prepared, polyester-lined self-expanding stent (DLS) as a control. Animals were sacrificed at 1 and 6 months. Biplanar arteriography and intravascular ultrasound were done at the time of sacrifice, and the vessels were harvested after perfusion fixation for histology/morphometry. Immunofluorescence with CD34 and factor VIII staining was used to evaluate endothelialization, while α-actin was used to quantify smooth muscle cell (SMC) deposition. Results: At 1 month, all vessels were patent in both groups. At 6 months, 8 of 9 vessels were open in the PLS group versus 6 of 9 in the control DLS group. Vessel lumen diameter at 1 month was significantly greater in the PLS vessels compared to the DLS group at 1 cm above the stent (35.9±4.4 versus 29.4±4.7 mm2; p=0.02) and 1 cm below the stent (37.2±7.1 versus 25.2±3.2 mm2; p=0.005); these results persisted to 6 months. Histological morphometry demonstrated progression of neointimal hyperplasia in the DLS stent between 30 and 180 days (8.3±1.79 versus 14.9±6.6 mm2; p=0.03), whereas the peritoneum-lined stent had no change during the same time period (4.62±0.98 versus 4.72±0.97 mm2; p=0.85). The same patterns were true for the intima:media ratio. Immunohistochemistry demonstrated complete endothelialization at 6 months in both DLS and PLS. However, SMC staining with α-actin demonstrated more smooth muscle actin-positive cells in the DLS compared to the PLS (327±87 versus 262±73 counts/5 high-powered fields; p=0.04). Conclusion: Peritoneum-lined stents offer a novel method to improve patency of lower extremity arterial stents.",
keywords = "Balloon injury model, Canine model, Neointimal hyperplasia, Peritoneum, Restenosis, Stent-graft",
author = "Kevin Carnevale and Kenneth Ouriel and Yves Gabriel and Daniel Clair and Bena, {James F.} and Michael Silva and Sarac, {Timur P.}",
year = "2006",
month = "4",
doi = "10.1583/05-1710R.1",
language = "English (US)",
volume = "13",
pages = "164--174",
journal = "Journal of Endovascular Therapy",
issn = "1526-6028",
publisher = "International Society of Endovascular Specialists",
number = "2",

}

TY - JOUR

T1 - Biological coating for arterial stents

T2 - The next evolutionary change in stents

AU - Carnevale, Kevin

AU - Ouriel, Kenneth

AU - Gabriel, Yves

AU - Clair, Daniel

AU - Bena, James F.

AU - Silva, Michael

AU - Sarac, Timur P.

PY - 2006/4

Y1 - 2006/4

N2 - Purpose: To describe the in vivo results of a promising new stent-graft lined with peritoneum. Methods: Eighteen dogs underwent balloon angioplasty injury to the bilateral iliac arteries followed by placement of either an 8-mm × 5-cm glutaraldehyde-fixed bovine peritoneum-lined balloon-expandable stent (PLS) or a similarly sized, commercially prepared, polyester-lined self-expanding stent (DLS) as a control. Animals were sacrificed at 1 and 6 months. Biplanar arteriography and intravascular ultrasound were done at the time of sacrifice, and the vessels were harvested after perfusion fixation for histology/morphometry. Immunofluorescence with CD34 and factor VIII staining was used to evaluate endothelialization, while α-actin was used to quantify smooth muscle cell (SMC) deposition. Results: At 1 month, all vessels were patent in both groups. At 6 months, 8 of 9 vessels were open in the PLS group versus 6 of 9 in the control DLS group. Vessel lumen diameter at 1 month was significantly greater in the PLS vessels compared to the DLS group at 1 cm above the stent (35.9±4.4 versus 29.4±4.7 mm2; p=0.02) and 1 cm below the stent (37.2±7.1 versus 25.2±3.2 mm2; p=0.005); these results persisted to 6 months. Histological morphometry demonstrated progression of neointimal hyperplasia in the DLS stent between 30 and 180 days (8.3±1.79 versus 14.9±6.6 mm2; p=0.03), whereas the peritoneum-lined stent had no change during the same time period (4.62±0.98 versus 4.72±0.97 mm2; p=0.85). The same patterns were true for the intima:media ratio. Immunohistochemistry demonstrated complete endothelialization at 6 months in both DLS and PLS. However, SMC staining with α-actin demonstrated more smooth muscle actin-positive cells in the DLS compared to the PLS (327±87 versus 262±73 counts/5 high-powered fields; p=0.04). Conclusion: Peritoneum-lined stents offer a novel method to improve patency of lower extremity arterial stents.

AB - Purpose: To describe the in vivo results of a promising new stent-graft lined with peritoneum. Methods: Eighteen dogs underwent balloon angioplasty injury to the bilateral iliac arteries followed by placement of either an 8-mm × 5-cm glutaraldehyde-fixed bovine peritoneum-lined balloon-expandable stent (PLS) or a similarly sized, commercially prepared, polyester-lined self-expanding stent (DLS) as a control. Animals were sacrificed at 1 and 6 months. Biplanar arteriography and intravascular ultrasound were done at the time of sacrifice, and the vessels were harvested after perfusion fixation for histology/morphometry. Immunofluorescence with CD34 and factor VIII staining was used to evaluate endothelialization, while α-actin was used to quantify smooth muscle cell (SMC) deposition. Results: At 1 month, all vessels were patent in both groups. At 6 months, 8 of 9 vessels were open in the PLS group versus 6 of 9 in the control DLS group. Vessel lumen diameter at 1 month was significantly greater in the PLS vessels compared to the DLS group at 1 cm above the stent (35.9±4.4 versus 29.4±4.7 mm2; p=0.02) and 1 cm below the stent (37.2±7.1 versus 25.2±3.2 mm2; p=0.005); these results persisted to 6 months. Histological morphometry demonstrated progression of neointimal hyperplasia in the DLS stent between 30 and 180 days (8.3±1.79 versus 14.9±6.6 mm2; p=0.03), whereas the peritoneum-lined stent had no change during the same time period (4.62±0.98 versus 4.72±0.97 mm2; p=0.85). The same patterns were true for the intima:media ratio. Immunohistochemistry demonstrated complete endothelialization at 6 months in both DLS and PLS. However, SMC staining with α-actin demonstrated more smooth muscle actin-positive cells in the DLS compared to the PLS (327±87 versus 262±73 counts/5 high-powered fields; p=0.04). Conclusion: Peritoneum-lined stents offer a novel method to improve patency of lower extremity arterial stents.

KW - Balloon injury model

KW - Canine model

KW - Neointimal hyperplasia

KW - Peritoneum

KW - Restenosis

KW - Stent-graft

UR - http://www.scopus.com/inward/record.url?scp=33750113469&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750113469&partnerID=8YFLogxK

U2 - 10.1583/05-1710R.1

DO - 10.1583/05-1710R.1

M3 - Article

C2 - 16643070

AN - SCOPUS:33750113469

VL - 13

SP - 164

EP - 174

JO - Journal of Endovascular Therapy

JF - Journal of Endovascular Therapy

SN - 1526-6028

IS - 2

ER -