Macroscopic and histological analysis of the vascular wall after implantation of a self-expanding nitinol stent: results of a preclinical in vivo study

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Abstract

Objective. To perform macroscopic and histological analysis of the vascular wall after implantation of a self-expanding nitinol stent in the in vivo experiment.

Material and methods. 2 Danish Landrace pigs were selected for experimental implantation of a new self-expanding nitinol stent with an oversizing of 5–20%. Vital signs were assessed in both pigs throughout the observation period. In the postoperative period, both animals received dual antiplatelet therapy for 3 months. After 3 months, the animals underwent control angiography and ultrasound examination of the iliofemoral segment, followed by withdrawal from the experiment by euthanasia. The next step was a morphological analysis of the stented areas of the vessels.

Results. The observation period of the animals was 3 months. Throughout the entire observation period, vital signs in both animals remained within normal values. Control angiography and ultrasound examination after 3 months demonstrated patency and the absence of significant restenoses in both pigs. Morphological analysis showed no signs of damage to the vessel walls.

Conclusion. This study showed a favorable response of the animal's body to the implantation of the presented self-expanding nitinol stent with minimal neointimal hyperplasia from the inner wall of the common iliac artery in the postoperative period.

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About the authors

E. V. Verkhovskaya

V.A. Almazov National Medical Research Center Ministry of Health of the Russia

Author for correspondence.
Email: verkhovskayakatya@gmail.com
Russian Federation, Saint Petersburg

A. Vanyurkin

V.A. Almazov National Medical Research Center Ministry of Health of the Russia

Email: verkhovskayakatya@gmail.com
Russian Federation, Saint Petersburg

Yu. Panteleeva

V.A. Almazov National Medical Research Center Ministry of Health of the Russia

Email: verkhovskayakatya@gmail.com
Russian Federation, Saint Petersburg

E. Poplavskii

V.A. Almazov National Medical Research Center Ministry of Health of the Russia

Email: verkhovskayakatya@gmail.com
Russian Federation, Saint Petersburg

A. Davudov

V.A. Almazov National Medical Research Center Ministry of Health of the Russia

Email: verkhovskayakatya@gmail.com
Russian Federation, Saint Petersburg

S. A. Samuilovskaya

V.A. Almazov National Medical Research Center Ministry of Health of the Russia

Email: verkhovskayakatya@gmail.com
Russian Federation, Saint Petersburg

A. Perminova

V.A. Almazov National Medical Research Center Ministry of Health of the Russia

Email: verkhovskayakatya@gmail.com
Russian Federation, Saint Petersburg

I. V. Antonova

V.A. Almazov National Medical Research Center Ministry of Health of the Russia

Email: verkhovskayakatya@gmail.com
Russian Federation, Saint Petersburg

A. Evdokimov

Research and Production Enterprises «MedEng»

Email: verkhovskayakatya@gmail.com

Cand. Sci. (Tech.)

Russian Federation, Penza

S. Evdokimov

Research and Production Enterprises «MedEng»

Email: verkhovskayakatya@gmail.com

Cand. Sci. (Tech.)

Russian Federation, Penza

M. Chernyavskii

V.A. Almazov National Medical Research Center Ministry of Health of the Russia

Email: verkhovskayakatya@gmail.com

Dr. Sci. (Med.)

Russian Federation, Saint Petersburg

References

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  2. Гавриленко А.В., Егоров А.А., Котов А.Е. и др. Хирургическое лечение больных с атеросклеротической окклюзией аорто-подвздошного сегмента в сочетании с поражением дистального русла. Ангиология и сосудистая хирургия. 2012; 18 (3): 101–5 [Gavrilenko A.V., Egorov A.A., Kotov A.E. et al. Surgical treatment of patients with atherosclerotic occlusion of the aortoiliac segment combined with distal-bed lesions. Angiology and Vascular Surgery. 2012; 18 (3): 101–5 (in Russ.)].
  3. Tang Q.H., Chen J., Hu C.F. et al. Comparison Between Endovascular and Open Surgery for the Treatment of Peripheral Artery Diseases: A Meta-Analysis. Ann Vasc Surg. 2020; 62: 484–95. doi: 10.1016/j.avsg.2019.06.039
  4. Duda S.H., Bosiers M., Lammer J. et al. Drug-eluting and bare nitinol stents for the treatment of atherosclerotic lesions in the superficial femoral artery: long-term results from the SIROCCO trial. J Endovasc Ther. 2006; 13 (6): 701–10. doi: 10.1583/05-1704.1
  5. Jeshari S., Die Loucou J., Leboffe M. et al. Preoperative Sizing to Lower In-Stent Restenosis in Peripheral Arterial Occlusive Disease. Ann Vasc Surg. 2024; 106: 37–50. doi: 10.1016/j.avsg.2024.02.017
  6. Saguner AM, Traupe T, Räber L, et al. Oversizing and restenosis with self-expanding stents in iliofemoral arteries. Cardiovasc Intervent Radiol. 2012;35(4):906-13. doi: 10.1007/s00270-011-0275-y.
  7. Bernini M., Colombo M., Dunlop C. et al. Oversizing of self-expanding Nitinol vascular stents – A biomechanical investigation in the superficial femoral artery. J Mech Behav Biomed Mater. 2022; 132: 105259. doi: 10.1016/j.jmbbm.2022.105259
  8. Li H., Rha S.W., Choi B.G. et al. Impact of chronic outward force on arterial responses of proximal and distal of long superficial femoral artery stent. BMC Cardiovasc Disord. 2021; 21 (1): 323. doi: 10.1186/s12872-021-02141-z

Supplementary files

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2. Fig. 1. Self-expanding nitinol stent with semi-closed cell structure

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3. Fig. 2. Preparation of the operating room in the Center for Preclinical and Translational Research of the Almazov National Medical Center

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4. Fig. 3. Puncture of the common femoral artery under ultrasound control

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5. Fig. 4. Diagnostic angiography: common iliac artery

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6. Fig. 5. Angiography during surgical intervention: a – stent inserted into the common iliac artery; б – control angiography immediately after stent implantation - optimal result

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7. Fig. 6. Preoperative preparation of the laboratory animal

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8. Fig. 7. Study design

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9. Fig. 8. Control angiography 3 months after surgery: the common iliac artery is passable

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10. Fig. 9. Ultrasound with measurement of blood flow spectral indices: patency of the stented section of the common iliac artery

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11. Fig. 10. Macropreparations of the section of the common iliac artery with a stent (а) and in the cut form (б)

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12. Fig. 11. Histologic preparations: wall thrombi made of fibrin with admixture of neutrophilic leukocytes (hematoxylin-eosin staining) (a) with preservation of internal elastic membrane (Weigert staining) (б)

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