title: Placement of endovascular stent across the branching arteries: long-term serial evaluation of stent-tissue responses overlying the arterial orifices in an experimental study.
abstract: OBJECTIVE
  This study was designed to investigate the effects of stenting across the branching arteries on the patency and stent-tissue responses over the branching arterial orifices.
  
  
  METHODS
  Thirteen dogs were observed after placing aortic stents across the celiac arteries (CA), superior mesenteric arteries (SMA), and renal arteries (RA). The animals were grouped according to stent types: large-cell group (n = 6) and small-cell group (n = 7). Angiography was performed to evaluate the branching artery patency at 2, 6, and 12 months after stent insertion, and the stent-tissue responses covering the orifices were evaluated on histopathologic examination.
  
  
  RESULTS
  All branching arteries were patent on follow-up angiography; however, three patterns of stent-tissue responses over the orifices were observed: neointimal layering, bridging septa, and papillary hyperplasia. Although neointimal layering and bridging septa were evenly observed, severe papillary hyperplasia was more frequent at SMA and CA than RA. Four RA showed less than 50% ostial patency, and localized infarct was observed in six kidneys (24%). The ostial patency tended to decrease with small-cell stent during the follow-up period.
  
  
  CONCLUSIONS
  Various stent-tissue responses over the branching artery orifices are induced by the aortic stent covering the branching arteries and may not be easily detected by conventional angiography. Subclinical renal infarct also may occur despite patent renal angiography.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Il
authors.initials: YI
authors.lastname: Kim
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Hyun Beom
authors.initials: HB
authors.lastname: Kim
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park
authors.forename: Jeong Wook
authors.initials: JW
authors.lastname: Seo
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Hwan Jun
authors.initials: HJ
authors.lastname: Jae
authors.forename: Whal
authors.initials: W
authors.lastname: Lee
mesh_terms: D000792:Angiography; D000818:Animals; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D004285:Dogs; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D015607:Stents; D014654:Vascular Patency