Tracheal Self-Expandable Metallic Stents: A Comparative Study of Three Different Stents in a Rabbit Model

详细信息    查看全文

• 作者：Carolina Serrano^a ; Fernando Lostalé ; ^a ; Francisco Rodrí ; guez-Panadero^b ; Ignacio de Blas^c ; Alicia Laborda^a ; Miguel Angel de Gregorio^a ; ^d ; ^{mgregori@unizar.es" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Stents ; Drug-eluting stents ; Tracheal stenosis ; Airway obstruction ; Animal models
• 刊名：Archivos de Bronconeumología (English Edition)
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：52
• 期：3
• 页码：123-130
• 全文大小：3356 K

文摘

The objective of this study was to assess tracheal reactivity after the deployment of different self-expandable metal stents (SEMS).

Material and methods

Forty female New Zealand rabbits were divided into four groups. Three groups received three different SEMS: steel (ST), nitinol (NiTi), or nitinol drug-eluting stent (DES); the fourth group was the control group (no stent).

Stents were deployed percutaneously under fluoroscopic guidance. Animals were assessed by multi-slice, computed tomography (CT) scans, and tracheas were collected for anatomical pathology (AP) study. Data from CT and AP were statistically analyzed and correlated.

Results

The DES group had the longest stenosis (20.51 ± 14.08 mm vs 5.84 ± 12.43 and 6.57 ± 6.54 mm in NiTi and ST, respectively, day 30; P<.05), and higher granuloma formation on CT (50% of cases). The NiTi group showed the lowest grade of stenosis (2.86 ± 6.91% vs 11.28 ± 13.98 and 15.54 ± 25.95% in DES and ST, respectively; P<.05).

The AP study revealed that the ST group developed intense proliferative reactivity compared to the other groups. In the DES group, a destructive response was observed in 70% of the animals, while the NiTi was the least reactive stent.

CT was more effective in detecting wall thickening (positive correlation of 68.9%; P<.001) than granuloma (not significant).

Conclusions

The ST group developed granulomas and significant stenosis. NiTi was the least reactive stent, while DES caused significant lesions that may be related to drug dosage. This type of DES stent is therefore not recommended for the treatment of tracheobronchial stenosis.