No subacute thrombosis and femoral bleeding complications under full anticoagulation in 150 consecutive patients receiving non-heparin-coated intracoronary Palmaz-Schatz stents

Carotid stenting using heparin-coated balloon-expandable stent reduces intimal hyperplasia in a baboon model

PURPOSE

This study evaluates the effect of heparin-coated balloon-expandable stents on intimal hyperplasia following carotid artery stenting in a baboon model.

MATERIALS AND METHODS

Balloon-expandable (Palmaz-Schatz) stents were placed in bilateral common carotid arteries in 26 male baboons (mean weight: 11.3 kg). In each animal, a heparin-coated (HC) carotid stent was placed on one side, whereas the contralateral carotid artery received an uncoated stent that served as a control. The carotid stents were harvested at 30 days (n = 13) and 90 days (n = 13). Arteriography was performed to assess the carotid patency, and intravascular ultrasound was used to determine neointimal and luminal areas. Histological, morphometric analysis, and scanning electron microscopy were performed in the stented carotid arteries.

RESULTS

One animal was excluded in each of the 1-month and 3-month groups because of premature death. Ten control (83%) and 11 HC stents (92%) remained patent in the 30-day group. In contrast, 10 control (83%) and 10 HC stents (83%) remained patent in the 90-day group. Morphometric analysis of the 30-day group showed the HC-stented carotid arteries had larger luminal areas (13%, P < 0.05), less neointimal areas (38%, P < 0.05), less neointimal/media ratios (53%, P < 0.05), and equivalent medial areas (NS) when compared with the control group. Morphometric analysis of the 90-day data showed the HC-stented carotid arteries had less neointimal areas (38%, P < 0.05) and less neointimal/media ratios (48%, P < 0.05), whereas the luminal areas and medial areas remained equivalent (NS) when compared with the control group.

CONCLUSIONS

Carotid stenting using heparin-coated stents reduces early intimal hyperplasia in a baboon model. This approach may represent a useful strategy for improving luminal patency in endovascular carotid intervention.

Heparin-coated balloon-expandable stent reduces intimal hyperplasia in the iliac artery in baboons

PURPOSE

To examine the effect of heparin-coated balloon-expandable iliac stent placement on intimal hyperplasia in a baboon model.

MATERIALS AND METHODS

Balloon-expandable (Palmaz-Schatz) stents were placed in bilateral common iliac arteries in 20 male baboons (mean weight: 8.8 kg). In each animal, a heparin-coated iliac stent was placed on one side and the contralateral iliac artery received an uncoated stent that served as a control. The iliac artery stents were harvested at 30 days (n = 10) and 90 days (n = 10). Arteriography was performed to assess iliac patency and intravascular ultrasonography was used to determine neointimal and luminal areas. Histologic and morphometric analysis and scanning electron microscopy were performed in the stent-implanted iliac arteries.

RESULTS

One animal was excluded in the 30-day group because of premature death. In the remaining nine surviving animals, seven control stents (78%) and nine heparin-coated stents (100%) remained patent. Morphometric analysis showed that the iliac arteries with heparin-coated stents had larger luminal areas (17%, P <.05), less neointimal area (26%, P <.05), lower neointima-to-media ratios (32%, P <.05), and equivalent medial areas (P =.92) compared to the control group at 30 days. In contrast, all control and heparin-coated stents were patent (100%) in the 90-day group. In that group, the heparin-coated stent group had less neointimal area (28%, P <.05), lower neointima-to-media ratios (42%, P <.05), and equivalent medial area (P =.92) and luminal area (P =.07) compared to the control group.

CONCLUSIONS

The data demonstrate that heparin-coated balloon-expandable stents reduce intimal hyperplasia after iliac artery stent placement. This approach may represent a useful strategy for prolonging luminal patency after iliac stent placement.