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Oversizing and restenosis with self-expanding stents in iliofemoral arteries.
- Source :
- CardioVascular & Interventional Radiology; Aug2012, Vol. 35 Issue 4, p906-913, 8p
- Publication Year :
- 2012
-
Abstract
- <bold>Purpose: </bold>Uncoated self-expanding nitinol stents (NS) are commonly oversized in peripheral arteries. In current practice, 1-mm oversizing is recommended. Yet, oversizing of NS may be associated with increased restenosis. To provide further evidence, NS were implanted in porcine iliofemoral arteries with a stent-to-artery-ratio between 1.0 and 2.3. Besides conventional uncoated NS, a novel self-expanding NS with an antiproliferative titanium-nitride-oxide (TiNOX) coating was tested for safety and efficacy. <bold>Methods: </bold>Ten uncoated NS and six TiNOX-coated NS (5-6 mm) were implanted randomly in the iliofemoral artery of six mini-pigs. After implantation, quantitative angiography (QA) was performed for calculation of artery and minimal luminal diameter. Follow-up was performed by QA and histomorphometry after 5 months. <bold>Results: </bold>Stent migration, stent fracture, or thrombus formation were not observed. All stents were patent at follow-up. Based on the location of the stent (iliac/femoral) and the stent-to-artery-ratio, stent segments were divided into "normal-sized" (stent-to-artery-ratio < 1.4, n = 12) and "oversized" (stent-to-artery-ratio ≥ 1.4, n = 9). All stent segments expanded to their near nominal diameter during follow-up. Normal-sized stent segments increased their diameter by 6% and oversized segments by 29%. A significant correlation between oversizing and restenosis by both angiography and histomorphometry was observed. Restenosis rates were similar for uncoated NS and TiNOX-coated NS. <bold>Conclusions: </bold>TiNOX-coated NS are as safe and effective as uncoated NS in the porcine iliofemoral artery. All stents further expand to near their nominal diameter during follow-up. Oversizing is linearly and positively correlated with neointimal proliferation and restenosis, which may not be reduced by TiNOX-coating. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01741551
- Volume :
- 35
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- CardioVascular & Interventional Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 104356711
- Full Text :
- https://doi.org/10.1007/s00270-011-0275-y