Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/S1677-54492010000200006
Jornal Vascular Brasileiro
Original Article

Análise morfométrica da carótida de suínos submetidos a angioplastia com ou sem implante de stent de cromo-cobalto

Morphometric analysis of swine carotid artery angioplasty with or without cobalt-chromium stent implantation

João Luiz de Lara Elesbão; Adamastor Humberto Pereira; Marco Aurélio Grüdtner; Fabiola Meyer

http://dx.doi.org/10.1590/S1677-54492010000200006 J Vasc Bras, vol.9, n2, p.40-46, 2010
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Resumo

Contexto: A hiperplasia intimal é a reação tardia mais comum decorrente da angioplastia. O uso de stents de cromo-cobalto é bem estudado na circulação coronariana, porém não há muitos estudos que abordem o uso desses stents nas circulações carotídea e periférica. Objetivo: Analisar mediante morfometria a reação intimal presente na artéria carótida de suínos submetidos a angioplastia isoladamente e a angioplastia seguida de implante de stent de cromo-cobalto. Materiais e métodos: Em oito suínos, foi realizada angioplastia da artéria carótida comum direita e angioplastia seguida de implante de um stent de cromo-cobalto na artéria carótida comum esquerda. Após 4 semanas, os animais foram submetidos a eutanásia para a retirada de amostras de tecido arterial e preparo de lâminas histológicas. As imagens das lâminas foram digitalizadas e analisadas por programa de morfometria digital. A análise estatística foi realizada através da média e desvio padrão das áreas em cada grupo, utilizando-se o Teste t de Student. O valor de p < 0,05 foi considerado significativo. Resultados: O implante do stent provocou maior grau de hiperplasia comparado à angioplastia isolada. A diferença em resposta ao implante de stent foi estatisticamente significativa quando as áreas do lúmen, da lâmina elástica interna e da lâmina elástica externa foram comparadas entre os dois grupos. Não se observou diferença significativa quando se realizou a comparação entre as camadas médias dos dois grupos. Conclusão: O implante de stent de cromo-cobalto gerou um espessamento intimal maior do que o produzido apenas pela angioplastia, porém ele não foi suficiente para reduzir o lúmen arterial.

Palavras-chave

Angioplastia, stents, suínos

Abstract

Background: Intimal hyperplasia is the most common delayed response to angioplasty. The use of cobalt-chromium stents is well studied in the coronary circulation; however, there are few studies on their use in the carotid and peripheral circulation. Objective: To analyze the intimal reaction in a swine carotid artery undergoing simple angioplasty and angioplasty followed by implantation of cobalt-chromium stent. Materials and methods: We carried out angioplasty in the right common carotid artery and angioplasty with cobalt-chromium stent in the left common carotid artery in eight swine. Four weeks later, all animals were sacrificed for arterial tissue sampling and preparation of histological slides. Slide images were scanned and analyzed using a digital morphometry program. Statistical analysis was performed by mean values and standard deviations of the areas in each group, using the Student's t test. A p value of < 0.05 was considered significant. Results: Angioplasty with cobalt-chromium stent implantation resulted in a higher degree of hyperplasia compared with simple angioplasty. The difference was statistically significant when the lumen area, the internal elastic lamina area, and the external elastic lamina area were compared between the two groups. No statistically significant difference was found when the media layers of both groups were compared. Conclusion: Cobalt-chromium stent implantation resulted in more intimal hyperplasia than simple angioplasty, however the stent was not enough to reduce the arterial lumen.

Keywords

Angioplasty, stents, swine

References

Fattori R, Piva T. Drug-eluting stents in vascular intervention. Lancet. 2003;361:247-9.

Inoue S, Koyama H, Miyata T, Shigematsu H. Pathogenetic heterogeneity of in-stent lesion formation in human peripheral arterial disease. J Vasc Surg. 2002;35:820-2.

Fischer A, Wienecke H, Brauer H, Erbel R. Metallic biomaterials for coronary stents. Z Kardiol. 2001;90:251-62.

Hansi C, Arab A, Rzany A, Ahrens I, Bode C, Hehrlein C. Differences of platelet adhesion and thrombus activation on amorphous silicon carbide, magnesium alloy, stainless steel, and cobalt chromium stent surfaces. Catheter Cardiovasc Interv. 2009;73:488-96.

Waksman R, Pakala R, Kuchulakanti PK. Safety and efficacy of bioabsorbable magnesium stents in porcine coronary arteries. Catheter Cardiovasc Interv. 2006;68:607-17.

Messer RL, Wataha JC, Lewis JB, Lockwood PE, Caughman GB, Tseng WY. Effect of vascular stent alloys on expression of cellular adhesion molecules by endothelial cells. J Long Term Eff Med Implants. 2005;15:39-47.

Gotman I. Characteristics of metals used in implants. J Endourol. 1997;11:383-9.

Koch W, Tiroch K, von Beckerath N, Schömig A, Kastrati A. Tumor necrosis factor-alpha, lymphotoxin-alpha, and interleukin-10 gene polymorphisms and restenosis after coronary artery stenting. Cytokine. 2003;24:161-71.

Versaci F, Gaspardone A. Prevention of restenosis after stenting: the emerging role of inflammation. Coron Artery Dis. 2004;15:307-11.

Welt FG, Rogers C. Inflammation and restenosis in the stent era. Arterioscler Thromb Vasc Biol. 2002;22:1769-76.

Ouriel K. Peripheral arterial disease. Lancet. 2001;358:1257-64.

Toutouzas K, Colombo A, Stefanadis C. Inflammation and restenosis after percutaneous coronary interventions. Eur Heart J. 2004;25:1679-87.

Cwikiel W, Harnek J, Zoucas E, Stenram U. Proliferative response in smooth muscle cells after angioplasty or insertion of self-expanding stents: An experimental study in pigs. Acta Radiol. 1997;38:124-8.

De Meyer GR, Bult H. Mechanisms of neointima formation: lessons from experimental models. Vasc Med. 1997;2:179-89.

Wolf YG, Gertz SD, Banai S. Animal models in syndromes of accelerated arteriosclerosis. Ann Vasc Surg. 1999;13:328-38.

Narayanaswany M, Wright K, Kandarpa K. Animal models for atherosclerosis, restenosis, and endovascular graft research. J Vasc Interv Radiol. 2000;11:5-17.

Tsai S, Butler J, Rafii S, Liu B, Kent KC. The role of progenitor cells in the development of intimal hyperplasia. J Vasc Surg. 2009;49:502-10.

Shi ZS, Feng L, He X. Vulnerable plaque in a Swine model of carotid atherosclerosis. AJNR Am J Neuroradiol. 2009;30:469-72.

França LH, Pereira AH, Perini SC. Self-expandable nitinol stent placement in homocysteinemic porcine aorta. Clinics. 2008;63:229-36.

Verheye S, Salame MY, Robinson KA. Short- and long-term histopathologic evaluation of stenting using a self-expanding nitinol stent in pig carotid and iliac arteries. Catheter Cardiovasc Interv. 1999;48:488-96.

Pasa MB, Pereira AH, Castro Junior C. Morphometric analysis of intimal thickening secondary to stent placement in pig carotid arteries. Acta Cir Bras. 2008;23:165-72.

Grudtner MA, Pereira AH, Costa LF, Souza GG, Argenta R, Longhi JA. Efeitos a curto prazo de stents não recobertos e recobertos com politetrafluoroetileno em aorta de suínos: um modelo experimental. Acta Cir Bras. 2004;19:120-5.

Dutra CF, Pereira AH. Digital morphometric analysis of the aortic wall in pigs following implantation of dacron-covered stents versus non-covered stents. Acta Cir Bras. 2004;19:210-219.

Castro Junior C, Pereira AH, Pasa MB. Morphometric analisis of intimal reaction after stent implantation in iliac arteries submitted to angioplasty in pigs. Acta Cir Bras. 2006;21:139-43.

Stampfl U, Sommer CM, Thierjung H. Reduction of late in-stent stenosis in a porcine coronary artery model by cobalt chromium stents with a nanocoat os polyphosphazene (Polyzene-F). Cardiovasc Intervent Radiol. 2008;31:1184-92.

Kereiakes DJ, Cox DA, Hermiller JB. Usefulness of a cobalt chromium coronary stent alloy. Am J Cardiol. 2003;92:463-6.

Santos MB. Ergonomia, carga mental de trabalho, riscos e prevenção de acidentes: o caso do trabalhador em histotécnica. 2007.

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