Early-Stage Vascular Response between Bare Metal Stent and Drug-Free Bioresorbable Vascular Scaffold in the Small-Sized Peripheral Artery: A Preclinical Study in Porcine Femoral Arteries

Ji Hun Ahn, Seung-Woon Rha, Byoung Geol Choi, Sang Ho Park, Woong Gil Choi, H. U. LI, Hye Yon Yu, Jin Su Byeon, Sang Ki Moon, Sang Tae Do

Research output: Contribution to journalArticle

Abstract

Background: The clinical benefits and outcomes of the interventional treatment of small-sized infrapopliteal arteries using stent implantation remain uncertain. The aim of this study was to compare the safety and efficacy of drug-free bioresorbable vascular scaffold (BVS) with that of bare metal stent (BMS) in endovascular treatment of small-sized peripheral arteries. Methods: In this study, drug-free BVS and BMS were used in eight porcine models. We compared the angiographic and histomorphometric findings in the two groups at 4 weeks. In each pig, BVS and BMS of adequate sizes were implanted in the small branch (<3 mm) of the femoral artery. Angiography, intravascular ultrasound (IVUS), and histomorphometric analysis were performed at 4 weeks. Results: In the 4-week follow-up angiography and IVUS examination, the minimal luminal diameter was smaller and diameter stenosis was more severe in the BVS group. Histomorphometric findings indicated that the lumen area in the BVS group was smaller (0.34 ± 0.28 mm2 vs. 1.40 ± 0.52 mm2, P < 0.001), whereas the neointimal area (2.70 ± 1.28 mm2 vs. 1.76 ± 0.66 mm2, P = 0.013), area stenosis (85.18 ± 13.14 % vs. 54.99 ± 16.13 %, P < 0.001), inflammatory score (2.07 ± 0.861 vs. 28 ± 0.39, P = 0.003), and fibrin scores (1.24 ± 0.70 vs. 0.79 ± 0.72, P = 0.043) were significantly higher in the BVS group. The injury score was higher in the BMS group. In histopathologic findings, restenosis was mainly due to recoil and distortion of the scaffold in the BVS group. Conclusions: Compared with BMS, drug-free BVS was not feasible for small-sized peripheral arteries based on the angiographic, IVUS, and histomorphometric results primarily due to insufficient mechanical support.

Original languageEnglish
JournalAnnals of Vascular Surgery
DOIs
Publication statusPublished - 2019 Jan 1

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Femoral Artery
Stents
Blood Vessels
Swine
Arteries
Metals
Pharmaceutical Preparations
Angiography
Pathologic Constriction
Fibrin
Safety
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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Early-Stage Vascular Response between Bare Metal Stent and Drug-Free Bioresorbable Vascular Scaffold in the Small-Sized Peripheral Artery : A Preclinical Study in Porcine Femoral Arteries. / Ahn, Ji Hun; Rha, Seung-Woon; Choi, Byoung Geol; Park, Sang Ho; Choi, Woong Gil; LI, H. U.; Yu, Hye Yon; Byeon, Jin Su; Moon, Sang Ki; Do, Sang Tae.

In: Annals of Vascular Surgery, 01.01.2019.

Research output: Contribution to journalArticle

Ahn, Ji Hun ; Rha, Seung-Woon ; Choi, Byoung Geol ; Park, Sang Ho ; Choi, Woong Gil ; LI, H. U. ; Yu, Hye Yon ; Byeon, Jin Su ; Moon, Sang Ki ; Do, Sang Tae. / Early-Stage Vascular Response between Bare Metal Stent and Drug-Free Bioresorbable Vascular Scaffold in the Small-Sized Peripheral Artery : A Preclinical Study in Porcine Femoral Arteries. In: Annals of Vascular Surgery. 2019.
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abstract = "Background: The clinical benefits and outcomes of the interventional treatment of small-sized infrapopliteal arteries using stent implantation remain uncertain. The aim of this study was to compare the safety and efficacy of drug-free bioresorbable vascular scaffold (BVS) with that of bare metal stent (BMS) in endovascular treatment of small-sized peripheral arteries. Methods: In this study, drug-free BVS and BMS were used in eight porcine models. We compared the angiographic and histomorphometric findings in the two groups at 4 weeks. In each pig, BVS and BMS of adequate sizes were implanted in the small branch (<3 mm) of the femoral artery. Angiography, intravascular ultrasound (IVUS), and histomorphometric analysis were performed at 4 weeks. Results: In the 4-week follow-up angiography and IVUS examination, the minimal luminal diameter was smaller and diameter stenosis was more severe in the BVS group. Histomorphometric findings indicated that the lumen area in the BVS group was smaller (0.34 ± 0.28 mm2 vs. 1.40 ± 0.52 mm2, P < 0.001), whereas the neointimal area (2.70 ± 1.28 mm2 vs. 1.76 ± 0.66 mm2, P = 0.013), area stenosis (85.18 ± 13.14 {\%} vs. 54.99 ± 16.13 {\%}, P < 0.001), inflammatory score (2.07 ± 0.861 vs. 28 ± 0.39, P = 0.003), and fibrin scores (1.24 ± 0.70 vs. 0.79 ± 0.72, P = 0.043) were significantly higher in the BVS group. The injury score was higher in the BMS group. In histopathologic findings, restenosis was mainly due to recoil and distortion of the scaffold in the BVS group. Conclusions: Compared with BMS, drug-free BVS was not feasible for small-sized peripheral arteries based on the angiographic, IVUS, and histomorphometric results primarily due to insufficient mechanical support.",
author = "Ahn, {Ji Hun} and Seung-Woon Rha and Choi, {Byoung Geol} and Park, {Sang Ho} and Choi, {Woong Gil} and LI, {H. U.} and Yu, {Hye Yon} and Byeon, {Jin Su} and Moon, {Sang Ki} and Do, {Sang Tae}",
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T1 - Early-Stage Vascular Response between Bare Metal Stent and Drug-Free Bioresorbable Vascular Scaffold in the Small-Sized Peripheral Artery

T2 - A Preclinical Study in Porcine Femoral Arteries

AU - Ahn, Ji Hun

AU - Rha, Seung-Woon

AU - Choi, Byoung Geol

AU - Park, Sang Ho

AU - Choi, Woong Gil

AU - LI, H. U.

AU - Yu, Hye Yon

AU - Byeon, Jin Su

AU - Moon, Sang Ki

AU - Do, Sang Tae

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The clinical benefits and outcomes of the interventional treatment of small-sized infrapopliteal arteries using stent implantation remain uncertain. The aim of this study was to compare the safety and efficacy of drug-free bioresorbable vascular scaffold (BVS) with that of bare metal stent (BMS) in endovascular treatment of small-sized peripheral arteries. Methods: In this study, drug-free BVS and BMS were used in eight porcine models. We compared the angiographic and histomorphometric findings in the two groups at 4 weeks. In each pig, BVS and BMS of adequate sizes were implanted in the small branch (<3 mm) of the femoral artery. Angiography, intravascular ultrasound (IVUS), and histomorphometric analysis were performed at 4 weeks. Results: In the 4-week follow-up angiography and IVUS examination, the minimal luminal diameter was smaller and diameter stenosis was more severe in the BVS group. Histomorphometric findings indicated that the lumen area in the BVS group was smaller (0.34 ± 0.28 mm2 vs. 1.40 ± 0.52 mm2, P < 0.001), whereas the neointimal area (2.70 ± 1.28 mm2 vs. 1.76 ± 0.66 mm2, P = 0.013), area stenosis (85.18 ± 13.14 % vs. 54.99 ± 16.13 %, P < 0.001), inflammatory score (2.07 ± 0.861 vs. 28 ± 0.39, P = 0.003), and fibrin scores (1.24 ± 0.70 vs. 0.79 ± 0.72, P = 0.043) were significantly higher in the BVS group. The injury score was higher in the BMS group. In histopathologic findings, restenosis was mainly due to recoil and distortion of the scaffold in the BVS group. Conclusions: Compared with BMS, drug-free BVS was not feasible for small-sized peripheral arteries based on the angiographic, IVUS, and histomorphometric results primarily due to insufficient mechanical support.

AB - Background: The clinical benefits and outcomes of the interventional treatment of small-sized infrapopliteal arteries using stent implantation remain uncertain. The aim of this study was to compare the safety and efficacy of drug-free bioresorbable vascular scaffold (BVS) with that of bare metal stent (BMS) in endovascular treatment of small-sized peripheral arteries. Methods: In this study, drug-free BVS and BMS were used in eight porcine models. We compared the angiographic and histomorphometric findings in the two groups at 4 weeks. In each pig, BVS and BMS of adequate sizes were implanted in the small branch (<3 mm) of the femoral artery. Angiography, intravascular ultrasound (IVUS), and histomorphometric analysis were performed at 4 weeks. Results: In the 4-week follow-up angiography and IVUS examination, the minimal luminal diameter was smaller and diameter stenosis was more severe in the BVS group. Histomorphometric findings indicated that the lumen area in the BVS group was smaller (0.34 ± 0.28 mm2 vs. 1.40 ± 0.52 mm2, P < 0.001), whereas the neointimal area (2.70 ± 1.28 mm2 vs. 1.76 ± 0.66 mm2, P = 0.013), area stenosis (85.18 ± 13.14 % vs. 54.99 ± 16.13 %, P < 0.001), inflammatory score (2.07 ± 0.861 vs. 28 ± 0.39, P = 0.003), and fibrin scores (1.24 ± 0.70 vs. 0.79 ± 0.72, P = 0.043) were significantly higher in the BVS group. The injury score was higher in the BMS group. In histopathologic findings, restenosis was mainly due to recoil and distortion of the scaffold in the BVS group. Conclusions: Compared with BMS, drug-free BVS was not feasible for small-sized peripheral arteries based on the angiographic, IVUS, and histomorphometric results primarily due to insufficient mechanical support.

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