title: Histopathological findings in a human carotid artery after stent implantation. Case report.
abstract: Despite the high technical success rates and the acceptable morbidity and mortality rates that are associated with carotid artery (CA) stent implantation, morphological changes in the vessel wall after this procedure are still unknown. The authors describe histopathological findings of the CA after stent implantation in a human autopsy specimen. A 75-year-old man with asymptomatic CA stenosis underwent successful CA stent implantation, but died 8 months afterward of complications surrounding treatment of a thoracic aortic artery aneurysm. The stented CA was isolated from the autopsy specimen and was analyzed macroscopically and with the aid of scanning electron microscopy and histopathological methods. Although there was focal persistence of a chronic inflammatory reaction around the stent struts, a stabilized neointima overlying the stent, which was principally composed of cells that stained positively for alpha-smooth muscle actin and collagen deposition with complete reendothelialization of the luminal surface, was confirmed in the internal CA. In contrast, residual mural thrombus around the stent struts in the common CA led to a concern about the potential risk for distal embolism in the future. The present case provides supportive evidence of stabilized neointima overlying the stent and valuable information regarding morphological characteristics useful for selecting a stent of an appropriate size.
authors.affiliation: Department of Neurosurgery, Mie University School of Medicine, Tsu, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Toma
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsushima
authors.forename: Kenichi
authors.initials: K
authors.lastname: Murao
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawaguchi
authors.forename: Kyoko
authors.initials: K
authors.lastname: Imanaka-Yoshida
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Waro
authors.initials: W
authors.lastname: Taki
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D011183:Postoperative Complications; D011859:Radiography; D015607:Stents / Q000009:adverse effects*; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology / Q000648:ultrastructure