Drug-eluting stents ameliorate pulmonary vein stenotic changes in pigs in vivo.
The outcome of stent implantation for pulmonary vein stenosis (PVS) in children remains poor. Several reports describe placing drug-eluting stents to treat PVS, but their effectiveness remains unknown. In this study, three bare-metal stents (BMSs) and three sirolimus-eluting stents (SESs) were implanted in 1-month-old pigs. The pigs were killed 8 weeks later to compare in-stent stenosis rates. The extent of neointimal thickness, as measured by injury score, was significantly less in the SES group than in the BMS group (injury score 1: BMS 0.351 + or - 0.033 vs SES 0.226 + or - 0.031 mm; P < 0.01; injury score 2: BMS 1.232 + or - 0.244 vs SES 0.609 + or - 0.208 mm; P < 0.01). The pathologic findings showed confluence of inflammatory cells around the stent wires in BMS-treated areas and granuloma formation. Granuloma formation was not seen with SES. The degree of in-stent stenosis was significantly reduced in the SES group, suggesting that the use of drug-eluting stents is an effective treatment for PVS. Because of the small sample size and the considerable variation in injury scores and balloon-to-vein ratios, future studies with larger samples are necessary.
Furukawa
Takeshi
T
Department of Pediatrics, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. furukawa.tks@gmail.com
Kishiro
Masahiko
M
Fukunaga
Hideo
H
Ohtsuki
Masahiro
M
Takahashi
Ken
K
Akimoto
Katsumi
K
Shimizu
Toshiaki
T
Kawasaki
Shiori
S
Kumasaka
Toshio
T
D000818:Animals; D004195:Disease Models, Animal; D054855:Drug-Eluting Stents; D005260:Female; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D011668:Pulmonary Veno-Occlusive Disease / Q000175:diagnosis / Q000601:surgery*; D055502:Secondary Prevention; D020123:Sirolimus / Q000494:pharmacology*; D016896:Treatment Outcome; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology
D007166:Immunosuppressive Agents; D020123:Sirolimus