Balloon-expandable intracoronary stents in the adult dog.

Schatz, Richard; Palmaz, Julio C.; Tio, Fermin O.; Garcı́a, Francisco; Garcia, O.; Reuter, Stewart R.

doi:10.1161/01.cir.76.2.450

Cited by 339 publications

(106 citation statements)

References 18 publications

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“…9 There is a gradual thinning of the in-stent neointima in canine coronary arteries by 12 months after stenting, accompanied by reduced cellularity and increased fibrosis. 38 In a study of stented porcine coronary arteries, Kim et al 34 reported a 33% reduction in stent area stenosis at 6 compared with 2 months.…”

Section: Neointimal Regressionmentioning

confidence: 99%

Extracellular Matrix Changes in Stented Human Coronary Arteries

et al. 2004

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Background-Restenosis after stenting occurs secondary to the accumulation of smooth muscle cells (SMCs) and extracellular matrix (ECM), with the ECM accounting for Ͼ50% of the neointimal volume. The composition of the in-stent ECM has not been well characterized in humans. Methods and Results-Postmortem human coronary arteries (nϭ45) containing stents underwent histological assessment of neointimal proteoglycans, hyaluronan, collagen (types I and III), SMCs, and CD44 (a cell surface receptor for hyaluronan). The mean duration of stent implantation was 18.7 months; stents in place Ն3 to Ͻ9 months (nϭ17) were assigned to group 1, stents Ն9 to Ͻ18 months old (nϭ19) to group 2, and stents Ն18 months old (nϭ9) to group 3. In groups 1 and 2, neointimal versican and hyaluronan staining was strongly positive, colocalized with ␣-actin-positive SMCs, and was greater in intensity compared with group 3. Conversely, decorin staining was greatest in group 3. The neointima of both group 1 and 2 stents was rich in type III collagen, with reduced staining in group 3. Type I collagen staining was weakest in group 1 stents, with progressively stronger staining in groups 2 and 3. SMC density and stent stenosis were significantly reduced in group 3 stents compared with groups 1 and 2. CD44 staining colocalized with macrophages and was associated with increased neointimal thickness. Conclusions-The ECM within human coronary stents resembles a wound that is not fully healed until 18 months after deployment, followed by neointimal retraction. ECM contraction may be a target for therapies aimed at stent restenosis prevention.

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Section: Neointimal Regressionmentioning

confidence: 99%

Extracellular Matrix Changes in Stented Human Coronary Arteries

et al. 2004

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“…These first stents were bare metal stents (BMS) and unfortunately were associated with a high incidence of subacute thrombosis in humans. [249,250]. This stent was subsequently modified to the Palmaz-Schatz stent, a heparin-coated stent [251][252][253].…”

Section: Intra-arterial Stentsmentioning

confidence: 99%

A Discussion of the Role of Complex Evolved Systems in the Development of Invasive Cardiovascular Interventions as Illustrated by the Blalock- Taussig Shunt and Intra-Arterial Stents

Greek¹

2014

Biol Syst Open Access

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Scientific disciplines normally thought of as outside the sphere of medical science have experienced advances over the past twenty years that currently have profound implications for medical care and medical research. Evolutionary and developmental biology, complexity and chaos science, along with the Human Genome Project and spinoff projects, have dramatically altered our understanding of how the human body functions and what can be expected from research methods like animal modeling. In this article, I summarize these advances and examine one historical medical development, the Blalock-Taussig shunt, in order to ascertain whether historically accepted representations of this development are consistent with current knowledge. I also examine an ongoing technology-intra-arterial stent development-to compare human data to the known animal data and place this comparison in the context of the aforementioned advances.

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“…Metallic stents were invented to compensate the recoiling of stretched vessel. 2) Stents sufficiently reduced a risk of acute closure after PCI, however, there remained a problem named in-stent restenosis characterized by an excessive neointimal hyperplasia inside the stent, which became the major limitation of coronary stents. In early 2000s, the advent of drug eluting stents (DES) brought a hope to overcome the limitation of stents with its pharmacological suppression of neointimal hyperplasia, and succeeded to improve the restenosis rate after implantation.…”

Section: Introductionmentioning

confidence: 99%