Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-28T11:58:29.298Z Has data issue: false hasContentIssue false
  • English
  • Français

Experimental studies on the implantation of intravascular stents in puppies—potential use for aortic coarctation and pulmonary arterial stenosis

Published online by Cambridge University Press:  19 August 2008

Toshihiro Ino ,
Shinjiro Shimazaki ,
Keijiro Yabuta  and
Ryozo Okada
Toshihiro Ino*
Affiliation:
From the Department of Pediatrics and the Cardiovascular Pathology Laboratory, Juntendo University School of Medicine, Tokyo
Shinjiro Shimazaki
Affiliation:
From the Department of Pediatrics and the Cardiovascular Pathology Laboratory, Juntendo University School of Medicine, Tokyo
Keijiro Yabuta
Affiliation:
From the Department of Pediatrics and the Cardiovascular Pathology Laboratory, Juntendo University School of Medicine, Tokyo
Ryozo Okada
Affiliation:
From the Department of Pediatrics and the Cardiovascular Pathology Laboratory, Juntendo University School of Medicine, Tokyo
*
Dr. Toshihiro mo, Department of Pediatrics, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113Japan. Tel. 03-3813-3111, ext. 3325.
Get access Rights & Permissions [Opens in a new window]

Abstract

We have investigated angiographically and histologically the vascular response to implantation of intravascular stents in normal puppies. Eight balloon-expandable stents were placed in six mongrel puppies (weight 6.4–10.5 kg) under anesthesia. Four stents were successfully placed in the pulmonary arteries and three in the aorta. In one case, the strut of the stent was hooked by a leaflet of the tricuspid valve at the time of placement and eventually had to be implanted in the inferior caval vein. Two puppies died, one from bleeding from the femoral artery and the other from thrombotic obstruction at the superior mesenteric artery, both after successful implantation. The former was due to repeat arterial puncture and the latter wasdue to failure to use aspirin. Angiographic studies showed satisfactory opacities of the branch arteries in all but one puppy. The diameter of the arteries prior to implantation was 7.5±1.5 mm. The diameters at the middle of the stents immediately after implantation and during the period of follow-up were 6.9±1.7mm and 6.9±2.1 mm, respectively. Histologic studies revealed that neogenic endothelial layers of 30 to 40 pm in thickness had formed over the struts of the stent without formation of thrombusthree weeks after implantation. Scanning electron microscopy revealed that the endothelial cells of the neoendothelial layer had almost identical characteristics to those of normal arteries. These results indicate that clinical application of this stent is feasible but that use of anticoagulants is mandatory during and after implantation in the treatment of selected patients with aortic coarctation or pulmonary arterial stenosis. Relative progression of stenosis may occur, however, and the inability for re-expansion is a major disadvantage of this stent.

Keywords

Intravascular stentcoarctation of the aortapulmonary arterial stenosisballoon angioplasty
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 4 , October 1994 , pp. 366 - 372
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Dotter, CT, Judkins, MP. Transluminal treatment of arterio sclerotic obstruction. Circulation. 1964; 30: 654–670.CrossRefGoogle Scholar
2.Palmaz, JC, Sibbit, RR, Tio, FO, Reuter, SR, Peters, JE, Garcia, F. Expandable intraluminal vascular graft: a feasible study. Surgery 1986; 99: 199–205.Google Scholar
3.Schatz, RA, Palmaz, JC, Tio, FO, Garcia, F, Garcia, S, Reuter, SR. Balloon expandable intracoronary stents in the adult dog. Circulation. 1987; 76: 450–457.CrossRefGoogle ScholarPubMed
4.Palmaz, JC, Sibitt, RR, Reuter, SR, Tio, FO, Rice, WJ. Expand able intraluminal graft: a preliminary study. Radiology 1985; 156: 73–77.CrossRefGoogle Scholar
5.Mullins, CE, O'Laughlin, MP, Vick, G. III, Mayer, DC, Myers, TJ, Kearney, PL, Schatz, RA, Palmaz, JC. Implantation of balloon-expandable intravascular grafts by catheterization in pulmonary arteries and systemic veins. Circulation 1988; 7: 188–199.CrossRefGoogle Scholar
6.O'Laughlin, MP, Perry, SB, Lock, JE, Mullins, CE. Use of endovascular stents in congenital heart disease. Circulation. 1991; 83: 1923–1939.CrossRefGoogle ScholarPubMed
7.Gibbs, JL, Rothman, MT, Rees, MR, Parson, LM, Blackburn, ME, Ruiz, CE. Stenting of the arterial duct: a new approach to palliation for pulmonary atresia. Br Heart J 1992; 67: 240–245.CrossRefGoogle ScholarPubMed
8.Rao, PS, Chopra, PS. Role of balloon angioplasty in the treatment of aortic coarctation. Ann. Thorac Surg. 1991; 52: 621–631.CrossRefGoogle ScholarPubMed
9.Rao, PS, Thapar, MK, Galal, O, Wilson, AD. Follow-up results of balloon angioplasty of native coarctation in neonates and infants. Am Heart J 1990; 120: 1310–1314.CrossRefGoogle ScholarPubMed
10.Lock, JE, Castañeda-Zuniga, WR, Fuhrman, BP, Bass, JL. Balloon dilation angioplasty of hypoplastic and stenotic Pul monary arteries. Circulation. 1983; 67: 963–967.CrossRefGoogle Scholar
11.Ring, JC, Bass, JL, Marvin, W, Fuhrman, BP, Kulik, TJ, Foker, JE, Lock, JE. Management of congenital branch pulmonary artery stenosis with balloon dilation angioplasty: Report of 52 procedures. J Thorac Cardiovasc Surg 1985; 90: 35–45.CrossRefGoogle ScholarPubMed
12.Strecker, EP, Liermann, D, Barth, KIH, Wolf, HRD, Freuden-berg, N, Berg, G, Westphal, M, Tsikuras, P, Savin, M, Schneider, U. Expandable tubular stents for treatment of arterial occlusive disease: Experimental and clinical results. Radiology 1990; 175: 97–102.CrossRefGoogle ScholarPubMed
13.Barth, KII, Virmani, R, Strecker, EP, Savin, MA, Lindisch, D, Matsumoto, AH, Teitelbaum, GP. Flexible tantalum stents implanted in aortas and iliac arteries: Effects in normal canines. Radiology 1990; 175: 91–96.CrossRefGoogle ScholarPubMed
14.Schatz, RA. A view of vascular stents. Circulation 1989; 79: 445–457.CrossRefGoogle ScholarPubMed
15.Bonan, R, Bhat, K, Lefevre, T, Lemarbre, L, Paiement, P, Wolff, R, Leung, TK. Coronary artery stenting after angioplasty with self-expandable parallel wire metallic stents. Am Heart J 1991; 121: 1522–1530.CrossRefGoogle ScholarPubMed
16.Palmaz, JC. Balloon-expandable intravascular stent. Am J Radiol 1988; 150: 1263–1269.Google ScholarPubMed
17.Wright, KC, Wallace-Charnsangavej, C, Carrasco, CH, Gianturco, C. Percutaneous endovascular stents: an experimental evaluation. Radiology 1985; 156: 69–72.CrossRefGoogle ScholarPubMed
18.Sigwart, W, Puel, J, Mirkowitch, V, Joffre, F, Kappenberger, L. Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty. New Engl j Med. 1987; 316: 701–706.CrossRefGoogle ScholarPubMed
19.Benson, LN, Hamilton, F, Dasmahapatra, H, Rabinowitch, M, Coles, JC, Freedom, RM. Percutaneous implantation of a balloon-expandable endoprosthesis for pulmonary artery stenosis: An experimental study. J Am Coll Cardiol 1991; 18: 1303–1308.CrossRefGoogle ScholarPubMed
20.Vick, GW III, O'Laughlin, M, Myers, T. Evaluation of aortic implantation and redilation of balloon expandable intravascular stents in juvenile minipigs. J Am Coll Cardiol 1989; 13:223 A. [abstract]Google Scholar