Carotid stenting using heparin-coated balloon-expandable stent reduces intimal hyperplasia in a baboon model.
OBJECTIVE
This study evaluates the effect of heparin-coated balloon-expandable stents on intimal hyperplasia following carotid artery stenting in a baboon model.


METHODS
Balloon-expandable (Palmaz-Schatz) stents were placed in bilateral common carotid arteries in 26 male baboons (mean weight: 11.3 kg). In each animal, a heparin-coated (HC) carotid stent was placed on one side, whereas the contralateral carotid artery received an uncoated stent that served as a control. The carotid stents were harvested at 30 days (n = 13) and 90 days (n = 13). Arteriography was performed to assess the carotid patency, and intravascular ultrasound was used to determine neointimal and luminal areas. Histological, morphometric analysis, and scanning electron microscopy were performed in the stented carotid arteries.


RESULTS
One animal was excluded in each of the 1-month and 3-month groups because of premature death. Ten control (83%) and 11 HC stents (92%) remained patent in the 30-day group. In contrast, 10 control (83%) and 10 HC stents (83%) remained patent in the 90-day group. Morphometric analysis of the 30-day group showed the HC-stented carotid arteries had larger luminal areas (13%, P < 0.05), less neointimal areas (38%, P < 0.05), less neointimal/media ratios (53%, P < 0.05), and equivalent medial areas (NS) when compared with the control group. Morphometric analysis of the 90-day data showed the HC-stented carotid arteries had less neointimal areas (38%, P < 0.05) and less neointimal/media ratios (48%, P < 0.05), whereas the luminal areas and medial areas remained equivalent (NS) when compared with the control group.


CONCLUSIONS
Carotid stenting using heparin-coated stents reduces early intimal hyperplasia in a baboon model. This approach may represent a useful strategy for improving luminal patency in endovascular carotid intervention.
Lin
Peter H
PH
Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Chronos
Nicolas A
NA
Marijianowski
Monique M
MM
Chen
Changyi
C
Conklin
Brian
B
Bush
Ruth L
RL
Lumsden
Alan B
AB
Hanson
Stephen R
SR
D000208:Acute Disease; D000818:Animals; D000925:Anticoagulants / Q000494:pharmacology*; D017536:Carotid Artery, Common / Q000473:pathology / Q000601:surgery*; D006493:Heparin / Q000494:pharmacology*; D006965:Hyperplasia; D008297:Male; D008855:Microscopy, Electron, Scanning; D010215:Papio; D011183:Postoperative Complications / Q000517:prevention & control; D015607:Stents; D013927:Thrombosis / Q000517:prevention & control*; D017539:Tunica Intima / Q000473:pathology
D000925:Anticoagulants; D006493:Heparin