Resistance of the Internal Mammary Artery to Restenosis: A Histomorphologic Study of Various Porcine Arteries

Horstick, Georg; Bierbach, Benjamin; Schlindwein, P.; Abegunewardene, Nico; Vosseler, Markus; Bittinger, Fernando; Becker, Dietmar; Lauterbach, Michael; Lehr, Hans‐Anton; Kempski, Oliver

doi:10.1159/000109076

Cited by 7 publications

(9 citation statements)

References 89 publications

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“…Second, although arterial responses are similar, the susceptibility of the elastic-natured aorta and iliac artery to injury is less when compared with a muscular coronary artery. 6,73 This ultimately can affect the degree of neointimal hyperplasia, thrombus formation, and inflammation, each of which may be intrinsically less in device studies using this model as compared with porcine coronary arteries. One characteristic attribute of the rabbit iliac arterial model is its tendency for delayed re-endothelial coverage postinjury, making this model more suitable for the comparative endoluminal evaluation of with respect to endothelial recovery and function.…”

Section: Rabbitmentioning

confidence: 99%

Preclinical Models of Restenosis and Their Application in the Evaluation of Drug-Eluting Stent Systems

Perkins

2010

Vet Pathol

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Coronary arterial disease (CAD) is the leading cause of death in the United States, the European Union, and Canada. Percutaneous coronary intervention (PCI) has revolutionized the treatment of CAD, and it is the advent of drug-eluting stent (DES) systems that has effectively allayed much of the challenge of restenosis that has plagued the success of PCI through its 30-year history. However, DES systems have not been a panacea: There yet remain the challenges associated with interventions involving bare metallic stents as well as newly arisen concerns related to the application of DES systems. To effectively address these novel and ongoing issues, animal models are relied on both to project the safety and efficacy of endovascular devices and to provide insight into the pathophysiology underlying the vascular response to injury and mechanisms of restenosis. In this review, preclinical models of restenosis are presented, and their application and limitation in the evaluation of device-based interventional technologies for the treatment of CAD are discussed.Keywords restenosis, stent, animal models, coronary artery disease Coronary artery disease (CAD) is the progressive accumulation of atherosclerotic plaque within the lumen of a coronary artery, with the typical result being luminal narrowing, reduced compliance of the vessel wall, and either a gradual reduction or a dramatic and sudden loss of blood supply to the myocardium. It is the leading cause of death in the United States, the European Union, and Canada, singly accounting for the death of 1 in 5 Americans. 117,185 In treatment options for symptomatic CAD, percutaneous coronary intervention (PCI) is the foremost modality, being based on the nonsurgical placement of a bare metallic scaffold, or stent, to prop open the artery to regain patency. However, there are drawbacks to coronary stenting, with restenosis being the Achilles' heel, accounting for a rate of failure up to 15 to 25%.18,124 Drug-eluting stents (DESs) have revolutionized PCI by effectively reducing restenosis rates to the single digits over standard bare metallic stents.DES systems combine mechanical and pharmacological approaches to assuage one or more events in the cascade that results in restenosis. These combination products consist of an intravascular scaffolding device that presents or releases single or multiple bioactive agents or pharmaceuticals into the bloodstream and arterial wall. Traditional DESs have consisted of a platform (stent), a carrier (usually a polymer), and an antirestenotic agent that is delivered locally to avert the need for high, systemically administered doses. The fundamental goal of the DES is to restore lumen patency while curtailing the diseased vessel's innate and often exuberant response to the implanted foreign material (stent) and to stent-induced injury. Despite the success of current DESs at achieving these goals, concerns have surfaced with their accruing clinical use. Such concerns pertain to vascular healing and late stent thrombosis, biocompat...

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Section: Rabbitmentioning

confidence: 99%

Preclinical Models of Restenosis and Their Application in the Evaluation of Drug-Eluting Stent Systems

Perkins

2010

Vet Pathol

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“…1). Thirty-nine German Landrace pigs of either sex weighing 29.2 ± 1.4 kg were prepared for PCI as recently published [4]. After quantitative vascular angiography of the proximal left arterial descending coronary artery (LAD) immediately distal to the first septal branch, a PTCA balloon was chosen with the matching diameter.…”

Section: Methodsmentioning

confidence: 99%

“…Histological examinations of the fibrosis and arterial density were performed by Sirius red staining and polarization microscopy on digitized images in a blinded fashion (fig. 3) [4, 12, 13]. The left ventricle was divided into 8 sectors starting at the LAD and counting in a clockwise manner (fig.…”

Section: Methodsmentioning

confidence: 99%

Critical Single Proximal Left Arterial Descending Coronary Artery Stenosis to Mimic Chronic Myocardial Ischemia: A New Model Induced by Minimal Invasive Technology

Horstick

Bierbach²,

Abegunewardene³

et al. 2008

J Vasc Res

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Background/Aims: The present report examines a new pig model for progressive induction of high-grade stenosis, for the study of chronic myocardial ischemia and the dynamics of collateral vessel growth. Methods: Thirty-nine Landrace pigs were instrumented with a novel experimental stent (GVD stent) in the left anterior descending coronary artery. Eight animals underwent transthoracic echocardiography at rest and under low-dose dobutamine. Seven animals were examined by nuclear PET and SPECT analysis. Epi-, mid- and endocardial fibrosis and the numbers of arterial vessels were examined by histology. Results: Functional analysis showed a significant decrease in global left ventricular ejection fraction (24.5 ± 1.6%) 3 weeks after implantation. There was a trend to increased left ventricular ejection fraction after low-dose dobutamine stress (36.0 ± 6.6%) and a significant improvement of the impaired regional anterior wall motion. PET and SPECT imaging documented chronic hibernation. Myocardial fibrosis increased significantly in the ischemic area with a gradient from epi- to endocardial. The number of arterial vessels in the ischemic area increased and coronary angiography showed abundant collateral vessels of Rentrop class 1. Conclusion: The presented experimental model mimics the clinical situation of chronic myocardial ischemia secondary to 1-vessel coronary disease.

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“…Three animals without coronary occlusion served as normal controls. The animals were pre-medicated and induced into anesthesia as previously published [23] .…”

Section: Experimental Protocolmentioning

confidence: 99%

Area at Risk and Viability after Myocardial Ischemia and Reperfusion Can Be Determined by Contrast-Enhanced Cardiac Magnetic Resonance Imaging

Vosseler¹,

Abegunewardene²,

Hoffmann³

et al. 2009

Eur Surg Res

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Background/Aims: Clinical differentiation between infarcted and viable myocardium in the ischemic area at risk is controversial. We investigated the potential of contrast-enhanced cardiac magnetic resonance imaging (ceCMRI) in determining the area at risk 24 h after ischemia. Methods: Myocardial ischemia was induced by percutaneous coronary intervention of the left anterior descending coronary artery in pigs. Coronary occlusion time was 30 min in group A, which caused little myocardial infarction and 45 min in group B, which led to irreversible damage. 24 h after reperfusion ceCMRI was performed at 2 and 15 min after administration of gadolinium-diethylenetriamine pentaacetic acid. The area at risk was determined by intravenous injection of Evans blue and myocardial viability by triphenyltetrazolium-chloride staining. Results: The signal-intense areas at 2 and 15 min after contrast administration matched the area at risk in groups A and B. Nonviable myocardium in group A was overestimated (14–15%) while good agreement was present in group B. Conclusion: The area at risk of reperfused ischemic myocardium can be determined by ceCMRI 24 h after coronary recanalization. This type of information might have relevant clinical implications in the treatment and stratification of patients with acute coronary syndrome in particular after surgical interventions.

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Resistance of the Internal Mammary Artery to Restenosis: A Histomorphologic Study of Various Porcine Arteries

Cited by 7 publications

References 89 publications

Preclinical Models of Restenosis and Their Application in the Evaluation of Drug-Eluting Stent Systems

Preclinical Models of Restenosis and Their Application in the Evaluation of Drug-Eluting Stent Systems

Critical Single Proximal Left Arterial Descending Coronary Artery Stenosis to Mimic Chronic Myocardial Ischemia: A New Model Induced by Minimal Invasive Technology

Area at Risk and Viability after Myocardial Ischemia and Reperfusion Can Be Determined by Contrast-Enhanced Cardiac Magnetic Resonance Imaging

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