Paired comparison of vascular wall reactions to Palmaz stents, Strecker tantalum stents, and Wallstents in canine iliac and femoral arteries

Klemens H. Barth, Renu Virmani, Jens Froelich, Toshiaki Takeda, Steven V. Lossef, Joseph Newsome, Russell Jones, David Lindisch

Research output: Contribution to journalArticle

Abstract

Background: 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. Methods and Results: 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-a-vis. Strecker stents, with follow-up of 2 and 4 months. In 7 dogs, Palmaz stents were placed vis-a-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 compare 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 by similar for Wallstents wire ends caused some wall trauma; several femoral Palmaz stents struts protruded through the media. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)2161-2169
Number of pages9
JournalCirculation
Volume93
Issue number12
DOIs
StatePublished - Jun 15 1996

Keywords

  • arteries
  • stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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