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Placement of Endovascular Stent across the Branching Arteries: Long-term Serial Evaluation of Stent-tissue Responses Overlying the Arterial Orifices in an Experimental Study

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Authors
Kim, Young Il; Chung, Jin Wook; Kim, Hyun Beom; Park, Jae Hyung; Seo, Jeong Wook; Kim, Hyo-Cheol; Jae, Hwan Jun; Lee, Whal
Issue Date
2012-12
Publisher
SPRINGER
Citation
CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY Vol.35 No.5, pp. 1154-1162
Keywords
복합학Endovascular procedureIntimal hyperplasiaBranching arteriesOrificeAnimal experiment
Abstract
This study was designed to investigate the effects of stenting across the branching arteries on the patency and stent-tissue responses over the branching arterial orifices.Thirteen dogs were observed after placing aortic stents across the celiac arteries (CA), superior mesenteric arteries (SMA), and renal arteries (RA). The animals were grouped according to stent types: large-cell group (n = 6) and small-cell group (n = 7). Angiography was performed to evaluate the branching artery patency at 2, 6, and 12 months after stent insertion, and the stent-tissue responses covering the orifices were evaluated on histopathologic examination.All branching arteries were patent on follow-up angiography; however, three patterns of stent-tissue responses over the orifices were observed: neointimal layering, bridging septa, and papillary hyperplasia. Although neointimal layering and bridging septa were evenly observed, severe papillary hyperplasia was more frequent at SMA and CA than RA. Four RA showed less than 50% ostial patency, and localized infarct was observed in six kidneys (24%). The ostial patency tended to decrease with small-cell stent during the follow-up period.Various stent-tissue responses over the branching artery orifices are induced by the aortic stent covering the branching arteries and may not be easily detected by conventional angiography. Subclinical renal infarct also may occur despite patent renal angiography.
Purpose This study was designed to investigate the
effects of stenting across the branching arteries on the
patency and stent-tissue responses over the branching
arterial orifices.
Methods Thirteen dogs were observed after placing aortic
stents across the celiac arteries (CA), superior mesenteric
arteries (SMA), and renal arteries (RA). The animals were
grouped according to stent types: large-cell group (n = 6)
and small-cell group (n = 7). Angiography was performed
to evaluate the branching artery patency at 2, 6, and
12 months after stent insertion, and the stent-tissue
responses covering the orifices were evaluated on histopathologic
examination.
Results All branching arteries were patent on followup
angiography; however, three patterns of stent-tissue
responses over the orifices were observed: neointimal layering,
bridging septa, and papillary hyperplasia. Although
neointimal layering and bridging septa were evenly
observed, severe papillary hyperplasia was more frequent at
SMA and CA than RA. Four RA showed less than 50% ostial
patency, and localized infarct was observed in six kidneys
ISSN
0174-1551
Language
English
URI
http://hdl.handle.net/10371/80108
DOI
https://doi.org/10.1007/s00270-011-0243-6
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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