Scanning Electron Microscopy Analysis of Luminal Inflammation Induced by Different Types of Coronary Stent in an Animal Model
文摘
There is histological evidence that drug-eluting stents are associated with delayed endothelialization and a persistent inflammatory state. Moreover, clusters of inflammatory cells have been observed on luminal surfaces by scanning electron microscopy. With the aim of quantifying this inflammatory response, we implanted one bare-metal stent and two drug-eluting stents containing different doses of vinblastine embedded in the same polymer into the coronary arteries of 12 domestic pigs. The density of inflammatory cells in a representative area (100 x 100 μm) was quantified at 3 and 7 days. Endothelialization was more complete in bare-metal stents than in drug-eluting stents at both 3 days (P = .016) and 7 days (P = .0001). The degree of inflammation induced by the drug-eluting stents was higher than that induced by the bare-metal stents at both 3 days (11.8 ± 3.5 % vs. 4.5 ± 2 % ; P = .001) and 7 days (26.3 ± 4.4 % vs. 1.2 ± 1.5 % ; P = .0001). In addition, the time sequence was inverted: the inflammatory response increased over time with the drug-eluting stents, while the opposite occurred with the bare-metal stents.
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