Histologic influence of paclitaxel-eluting covered metallic stents in a canine biliary model.
BACKGROUND
Metallic stents for malignant biliary obstruction are susceptible to occlusion by tumor ingrowth or overgrowth. Paclitaxel-eluting metallic stents (PEMSs), however, may prevent occlusion from tumor ingrowth.


OBJECTIVE
We evaluated the safety of PEMSs in a canine biliary model by analyzing tissue reactions by histologic examination.


METHODS
Animal study.


METHODS
Six PEMSs and 5 control stents (CSs) were endoscopically placed in the bile ducts of 11 mongrel dogs and followed up for 6 weeks.


METHODS
The animals were euthanized at 6 weeks, and gross and microhistologic examinations were done. A comparison was made between dogs with PEMSs and dogs with CSs.


RESULTS
All 11 stents were successfully placed in the bile ducts, although the distal ends of 2 PEMSs were partially exposed to the duodenal lumen. All 11 dogs survived until death without evidence of jaundice. Gross histologic examination showed mucosal hyperplasia in 3 of 6 dogs in the PEMS group, but there was no evidence of mucosal hyperplasia in the CS group. Microscopically, the epithelial layers at the middle and distal ends of the stented segments were significantly thicker in the PEMS dogs than in the CS group.


CONCLUSIONS
Placement of PEMSs in normal canine bile ducts was without significant technical complications; however, local drug delivery from the PEMS resulted in significant histologic changes. Therefore, it is important to choose a drug in adequate concentrations to exert an antitumor effect without damaging the adjacent normal bilary mucosa.
Lee
Sang Soo
SS
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul.
Shin
Ji Hoon
JH
Han
Ji Min
JM
Cho
Chang Ho
CH
Kim
Myung-Hwan
MH
Lee
Sung-Koo
SK
Kim
Jin-Hyoung
JH
Kim
Kyung-Rae
KR
Shin
Kyoung Min
KM
Won
Yong Hyun
YH
Song
Ho-Young
HY
D000818:Animals; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D020099:Coated Materials, Biocompatible; D003135:Common Bile Duct / Q000187:drug effects* / Q000473:pathology*; D004195:Disease Models, Animal; D004285:Dogs; D054855:Drug-Eluting Stents; D004848:Epithelium / Q000187:drug effects / Q000473:pathology; D004869:Equipment Safety; D006965:Hyperplasia / Q000139:chemically induced / Q000473:pathology; D008297:Male; D009092:Mucous Membrane / Q000187:drug effects / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage*; D011140:Polyurethanes
D000972:Antineoplastic Agents, Phytogenic; D020099:Coated Materials, Biocompatible; D011140:Polyurethanes; D017239:Paclitaxel