Oversizing of Self-Expanding Stents: Influence on the Development of Neointimal Hyperplasia of the Carotid Artery in a Canine Model

In carotid artery stent placement, marked oversizing of the stent relative to the internal carotid artery lumen is common. This study was performed to determine the influence of using oversized self-expanding nitinol stents on neointimal hyperplasia. In six greyhound dogs, 24 self-expanding nitinol...

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Bibliographic Details
Published in:	American journal of neuroradiology : AJNR Vol. 23; no. 1; pp. 121 - 127
Main Authors:	Kirsch, Eberhard C, Khangure, Mark S, Morling, Philip, York, Terry J, McAuliffe, William
Format:	Journal Article
Language:	English
Published:	Oak Brook, IL Am Soc Neuroradiology 01-01-2002 American Society of Neuroradiology
Subjects:	Animals Biological and medical sciences Carotid Artery, Internal - pathology Diseases of the nervous system Dogs Equipment Failure Analysis Fibromuscular Dysplasia - pathology Image Processing, Computer-Assisted Interventional Medical sciences Prosthesis Design Prosthesis Fitting Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Stents Tunica Intima - pathology Fissipedia Animal model Carnivora Radiodiagnosis Angiography Hyperplasia Instrumentation therapy Exploration Stent Pathology Vertebrata Optical microscopy Mammalia Animal Carotid Dog
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Summary:	In carotid artery stent placement, marked oversizing of the stent relative to the internal carotid artery lumen is common. This study was performed to determine the influence of using oversized self-expanding nitinol stents on neointimal hyperplasia. In six greyhound dogs, 24 self-expanding nitinol stents (eight SMART stents, eight Easy Wallstents, eight Sinus-Flex stents) were inserted into both common carotid arteries (CCAs). In each CCA, two stents were deployed; a stent of the appropriate diameter was implanted distally and an oversized stent proximally. After 4 months, transverse sections of each stent were examined histologically and at computerized image analysis. Neointimal hyperplasia was determined as the proportion of the residual diameter of the patent vessel lumen compared with the stent lumen. The amount of neointimal hyperplasia did not differ between the normal-sized and oversized stents. The mean preserved luminal diameter (+/-SEM) with normal- and oversized stents, respectively, were as follows: Easy Wallstent, 94% +/- 1.0 and 96% +/- 1.5; SMART stent, 92% +/- 1.6 and 93% +/- 1.8; and Sinus-Flex stent, 93% +/- 2.7 and 93% +/- 2.6. The mean preserved patent lumen with the 12 normal-sized stents (93% +/-1.0) was not significantly different from that of the 12 oversized stents (94% +/- 1.1, P =.502). Under experimental conditions, use of self-expanding stents oversized by 30-40% appeared to result in neointimal hyperplasia comparable to that caused by normal-sized stents. All three stent types appeared to have similarly low neointimal responses.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0195-6108 1936-959X