Paired comparison of vascular wall reactions to Palmaz stents, Strecker tantalum stents, and wallstents in canine iliac and femoral arteries
Palmaz stents, Strecker stents, and Wallstents, all used clinically, differ substantially in their physical characteristics, yet how differently the vascular wall reacts to them has not been demonstrated conclusively. We therefore undertook a side-by-side comparison. One stent was implanted into eac...
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Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1996-06, Vol.93 (12), p.2161-2169 |
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description | Palmaz stents, Strecker stents, and Wallstents, all used clinically, differ substantially in their physical characteristics, yet how differently the vascular wall reacts to them has not been demonstrated conclusively. We therefore undertook a side-by-side comparison.
One stent was implanted into each canine external iliac and/or the flexing portion of the proximal femoral artery. In 9 dogs, Palmaz stents were placed vis-à-vis Strecker stents, with follow-up of 2 and 4 months. In 7 dogs, Palmaz stents were placed vis-à-vis Wallstents, with 4 months of follow-up. Angiographic midstent luminal diameters immediately after placement and at follow-up as well as midstent cross-sectional areas of neointima were compared for significant differences. In addition, neointimal maturation, medial atrophy, and stent-related trauma were assessed. Angiographically, all arteries remained open. The degree of luminal narrowing by recoil and neointima never reached 50% and was modest for Palmaz stents and Wallstents (P = .33) but significantly higher for Strecker stents (P < .0001 compared with Palmaz stents). This corresponded histologically to a significantly thicker neointima (P = .003) over Strecker than over Palmaz stents but not between Palmaz stents and Wallstents (P = .18). Neointimal buildup was generally more pronounced in the femoral artery segments than in the iliac segments. Maturation of the neointima over Palmaz stents was much further advanced than over Strecker stents and slightly more advanced than over Wallstents. Pressure-related atrophy of the tunica media was least for Strecker stents and more pronounced but similar for Wallstents and Palmaz stents. Wallstent wire ends caused some wall trauma; several femoral Palmaz stent struts protruded through the media.
The lower-hoop-strength, higher-profile tantalum Strecker stent is affected by vascular wall recoil and evokes a greater degree of neointima formation than the lower-profile, higher-hoop-strength Palmaz stent and Wallstent. Medial atrophy is pronounced outside the latter two stents. The rigid Palmaz stent can penetrate through the vascular wall in flexing arteries. |
doi_str_mv | 10.1161/01.cir.93.12.2161 |
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One stent was implanted into each canine external iliac and/or the flexing portion of the proximal femoral artery. In 9 dogs, Palmaz stents were placed vis-à-vis Strecker stents, with follow-up of 2 and 4 months. In 7 dogs, Palmaz stents were placed vis-à-vis Wallstents, with 4 months of follow-up. Angiographic midstent luminal diameters immediately after placement and at follow-up as well as midstent cross-sectional areas of neointima were compared for significant differences. In addition, neointimal maturation, medial atrophy, and stent-related trauma were assessed. Angiographically, all arteries remained open. The degree of luminal narrowing by recoil and neointima never reached 50% and was modest for Palmaz stents and Wallstents (P = .33) but significantly higher for Strecker stents (P < .0001 compared with Palmaz stents). This corresponded histologically to a significantly thicker neointima (P = .003) over Strecker than over Palmaz stents but not between Palmaz stents and Wallstents (P = .18). Neointimal buildup was generally more pronounced in the femoral artery segments than in the iliac segments. Maturation of the neointima over Palmaz stents was much further advanced than over Strecker stents and slightly more advanced than over Wallstents. Pressure-related atrophy of the tunica media was least for Strecker stents and more pronounced but similar for Wallstents and Palmaz stents. Wallstent wire ends caused some wall trauma; several femoral Palmaz stent struts protruded through the media.
The lower-hoop-strength, higher-profile tantalum Strecker stent is affected by vascular wall recoil and evokes a greater degree of neointima formation than the lower-profile, higher-hoop-strength Palmaz stent and Wallstent. Medial atrophy is pronounced outside the latter two stents. The rigid Palmaz stent can penetrate through the vascular wall in flexing arteries.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.93.12.2161</identifier><identifier>PMID: 8925585</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Animals ; Biological and medical sciences ; Diseases of the cardiovascular system ; Dogs ; Female ; Femoral Artery - diagnostic imaging ; Femoral Artery - pathology ; Femoral Artery - physiopathology ; Foreign-Body Reaction - diagnostic imaging ; Foreign-Body Reaction - pathology ; Foreign-Body Reaction - physiopathology ; Iliac Artery - diagnostic imaging ; Iliac Artery - pathology ; Iliac Artery - physiopathology ; Male ; Medical sciences ; Radiography ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Stents - adverse effects ; Tantalum ; Tunica Intima - pathology ; Tunica Intima - physiopathology ; Wounds, Penetrating - etiology</subject><ispartof>Circulation (New York, N.Y.), 1996-06, Vol.93 (12), p.2161-2169</ispartof><rights>1996 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Jun 15, 1996</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c460t-ed5b0dee8d17f295b6916ce26876d803009fd103633c214590d9671c7e31ec5b3</citedby><cites>FETCH-LOGICAL-c460t-ed5b0dee8d17f295b6916ce26876d803009fd103633c214590d9671c7e31ec5b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3111638$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8925585$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BARTH, K. H</creatorcontrib><creatorcontrib>VIRMANI, R</creatorcontrib><creatorcontrib>FROELICH, J</creatorcontrib><creatorcontrib>TAKEDA, T</creatorcontrib><creatorcontrib>LOSSEF, S. V</creatorcontrib><creatorcontrib>NEWSOME, J</creatorcontrib><creatorcontrib>JONES, R</creatorcontrib><creatorcontrib>LINDISCH, D</creatorcontrib><title>Paired comparison of vascular wall reactions to Palmaz stents, Strecker tantalum stents, and wallstents in canine iliac and femoral arteries</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Palmaz stents, Strecker stents, and Wallstents, all used clinically, differ substantially in their physical characteristics, yet how differently the vascular wall reacts to them has not been demonstrated conclusively. We therefore undertook a side-by-side comparison.
One stent was implanted into each canine external iliac and/or the flexing portion of the proximal femoral artery. In 9 dogs, Palmaz stents were placed vis-à-vis Strecker stents, with follow-up of 2 and 4 months. In 7 dogs, Palmaz stents were placed vis-à-vis Wallstents, with 4 months of follow-up. Angiographic midstent luminal diameters immediately after placement and at follow-up as well as midstent cross-sectional areas of neointima were compared for significant differences. In addition, neointimal maturation, medial atrophy, and stent-related trauma were assessed. Angiographically, all arteries remained open. The degree of luminal narrowing by recoil and neointima never reached 50% and was modest for Palmaz stents and Wallstents (P = .33) but significantly higher for Strecker stents (P < .0001 compared with Palmaz stents). This corresponded histologically to a significantly thicker neointima (P = .003) over Strecker than over Palmaz stents but not between Palmaz stents and Wallstents (P = .18). Neointimal buildup was generally more pronounced in the femoral artery segments than in the iliac segments. Maturation of the neointima over Palmaz stents was much further advanced than over Strecker stents and slightly more advanced than over Wallstents. Pressure-related atrophy of the tunica media was least for Strecker stents and more pronounced but similar for Wallstents and Palmaz stents. Wallstent wire ends caused some wall trauma; several femoral Palmaz stent struts protruded through the media.
The lower-hoop-strength, higher-profile tantalum Strecker stent is affected by vascular wall recoil and evokes a greater degree of neointima formation than the lower-profile, higher-hoop-strength Palmaz stent and Wallstent. Medial atrophy is pronounced outside the latter two stents. The rigid Palmaz stent can penetrate through the vascular wall in flexing arteries.</description><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Diseases of the cardiovascular system</subject><subject>Dogs</subject><subject>Female</subject><subject>Femoral Artery - diagnostic imaging</subject><subject>Femoral Artery - pathology</subject><subject>Femoral Artery - physiopathology</subject><subject>Foreign-Body Reaction - diagnostic imaging</subject><subject>Foreign-Body Reaction - pathology</subject><subject>Foreign-Body Reaction - physiopathology</subject><subject>Iliac Artery - diagnostic imaging</subject><subject>Iliac Artery - pathology</subject><subject>Iliac Artery - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Radiography</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Stents - adverse effects</subject><subject>Tantalum</subject><subject>Tunica Intima - pathology</subject><subject>Tunica Intima - physiopathology</subject><subject>Wounds, Penetrating - etiology</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUUuLFDEQDqKs4-gP8CAEEU92m0o66e7jMvhYWHDxcQ6ZdDVkTSdjklb0N_ijze4Mc_BUVH2PquIj5DmwFkDBWwatdakdRQu85XXygGxA8q7ppBgfkg1jbGx6wflj8iTn29oq0csLcjGMXMpBbsjfG-MSTtTG5WCSyzHQONOfJtvVm0R_Ge9pQmOLiyHTEumN8Yv5Q3PBUPIb-qUktN8x0WJCMX5dzogJ07382FMXqDXBBaTOO2Pv4RmXmIynJhVMDvNT8mg2PuOzU92Sb-_ffd19bK4_fbjaXV43tlOsNDjJPZsQhwn6mY9yr0ZQFrkaejUNTNSn5wmYUEJYDp0c2TSqHmyPAtDKvdiS10ffQ4o_VsxFLy5b9N4EjGvW_QCs47yvxJf_EW_jmkK9TXPgPZeq7tgSOJJsijknnPUhucWk3xqYvotJM9C7q896FBq4voupal6cjNf9gtNZccql4q9OeE3C-DmZYF0-0wRUXzGIf0MfnAk</recordid><startdate>19960615</startdate><enddate>19960615</enddate><creator>BARTH, K. H</creator><creator>VIRMANI, R</creator><creator>FROELICH, J</creator><creator>TAKEDA, T</creator><creator>LOSSEF, S. V</creator><creator>NEWSOME, J</creator><creator>JONES, R</creator><creator>LINDISCH, D</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19960615</creationdate><title>Paired comparison of vascular wall reactions to Palmaz stents, Strecker tantalum stents, and wallstents in canine iliac and femoral arteries</title><author>BARTH, K. H ; VIRMANI, R ; FROELICH, J ; TAKEDA, T ; LOSSEF, S. V ; NEWSOME, J ; JONES, R ; LINDISCH, D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c460t-ed5b0dee8d17f295b6916ce26876d803009fd103633c214590d9671c7e31ec5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Diseases of the cardiovascular system</topic><topic>Dogs</topic><topic>Female</topic><topic>Femoral Artery - diagnostic imaging</topic><topic>Femoral Artery - pathology</topic><topic>Femoral Artery - physiopathology</topic><topic>Foreign-Body Reaction - diagnostic imaging</topic><topic>Foreign-Body Reaction - pathology</topic><topic>Foreign-Body Reaction - physiopathology</topic><topic>Iliac Artery - diagnostic imaging</topic><topic>Iliac Artery - pathology</topic><topic>Iliac Artery - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Radiography</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Stents - adverse effects</topic><topic>Tantalum</topic><topic>Tunica Intima - pathology</topic><topic>Tunica Intima - physiopathology</topic><topic>Wounds, Penetrating - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BARTH, K. H</creatorcontrib><creatorcontrib>VIRMANI, R</creatorcontrib><creatorcontrib>FROELICH, J</creatorcontrib><creatorcontrib>TAKEDA, T</creatorcontrib><creatorcontrib>LOSSEF, S. V</creatorcontrib><creatorcontrib>NEWSOME, J</creatorcontrib><creatorcontrib>JONES, R</creatorcontrib><creatorcontrib>LINDISCH, D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BARTH, K. H</au><au>VIRMANI, R</au><au>FROELICH, J</au><au>TAKEDA, T</au><au>LOSSEF, S. V</au><au>NEWSOME, J</au><au>JONES, R</au><au>LINDISCH, D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Paired comparison of vascular wall reactions to Palmaz stents, Strecker tantalum stents, and wallstents in canine iliac and femoral arteries</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1996-06-15</date><risdate>1996</risdate><volume>93</volume><issue>12</issue><spage>2161</spage><epage>2169</epage><pages>2161-2169</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Palmaz stents, Strecker stents, and Wallstents, all used clinically, differ substantially in their physical characteristics, yet how differently the vascular wall reacts to them has not been demonstrated conclusively. We therefore undertook a side-by-side comparison.
One stent was implanted into each canine external iliac and/or the flexing portion of the proximal femoral artery. In 9 dogs, Palmaz stents were placed vis-à-vis Strecker stents, with follow-up of 2 and 4 months. In 7 dogs, Palmaz stents were placed vis-à-vis Wallstents, with 4 months of follow-up. Angiographic midstent luminal diameters immediately after placement and at follow-up as well as midstent cross-sectional areas of neointima were compared for significant differences. In addition, neointimal maturation, medial atrophy, and stent-related trauma were assessed. Angiographically, all arteries remained open. The degree of luminal narrowing by recoil and neointima never reached 50% and was modest for Palmaz stents and Wallstents (P = .33) but significantly higher for Strecker stents (P < .0001 compared with Palmaz stents). This corresponded histologically to a significantly thicker neointima (P = .003) over Strecker than over Palmaz stents but not between Palmaz stents and Wallstents (P = .18). Neointimal buildup was generally more pronounced in the femoral artery segments than in the iliac segments. Maturation of the neointima over Palmaz stents was much further advanced than over Strecker stents and slightly more advanced than over Wallstents. Pressure-related atrophy of the tunica media was least for Strecker stents and more pronounced but similar for Wallstents and Palmaz stents. Wallstent wire ends caused some wall trauma; several femoral Palmaz stent struts protruded through the media.
The lower-hoop-strength, higher-profile tantalum Strecker stent is affected by vascular wall recoil and evokes a greater degree of neointima formation than the lower-profile, higher-hoop-strength Palmaz stent and Wallstent. Medial atrophy is pronounced outside the latter two stents. The rigid Palmaz stent can penetrate through the vascular wall in flexing arteries.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>8925585</pmid><doi>10.1161/01.cir.93.12.2161</doi><tpages>9</tpages></addata></record> |
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source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
subjects | Animals Biological and medical sciences Diseases of the cardiovascular system Dogs Female Femoral Artery - diagnostic imaging Femoral Artery - pathology Femoral Artery - physiopathology Foreign-Body Reaction - diagnostic imaging Foreign-Body Reaction - pathology Foreign-Body Reaction - physiopathology Iliac Artery - diagnostic imaging Iliac Artery - pathology Iliac Artery - physiopathology Male Medical sciences Radiography Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Stents - adverse effects Tantalum Tunica Intima - pathology Tunica Intima - physiopathology Wounds, Penetrating - etiology |
title | Paired comparison of vascular wall reactions to Palmaz stents, Strecker tantalum stents, and wallstents in canine iliac and femoral arteries |
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