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Comparative Study
. 2011 Mar;84(999):210-5.
doi: 10.1259/bjr/21667521.

Comparison of diamond-like carbon-coated nitinol stents with or without polyethylene glycol grafting and uncoated nitinol stents in a canine iliac artery model

J H Kim  1 , J H Shin, D H Shin, M-W Moon, K Park, T-H Kim, K M Shin, Y H Won, D K Han, K-R Lee
Affiliations
Comparative Study

Comparison of diamond-like carbon-coated nitinol stents with or without polyethylene glycol grafting and uncoated nitinol stents in a canine iliac artery model

J H Kim et al. Br J Radiol. 2011 Mar.

Abstract

Objective: Neointimal hyperplasia is a major complication of endovascular stent placement with consequent in-stent restenosis or occlusion. Improvements in the biocompatibility of stent designs could reduce stent-associated thrombosis and in-stent restenosis. We hypothesised that the use of a diamond-like carbon (DLC)-coated nitinol stent or a polyethylene glycol (PEG)-DLC-coated nitinol stent could reduce the formation of neointimal hyperplasia, thereby improving stent patency with improved biocompatibility.

Methods: A total of 24 stents were implanted, under general anaesthesia, into the iliac arteries of six dogs (four stents in each dog) using the carotid artery approach. The experimental study dogs were divided into three groups: the uncoated nitinol stent group (n = 8), the DLC-nitinol stent group (n = 8) and the PEG-DLC-nitinol stent group (n = 8).

Results: The mean percentage of neointimal hyperplasia was significantly less in the DLC-nitinol stent group (26.7±7.6%) than in the nitinol stent group (40.0±20.3%) (p = 0.021). However, the mean percentage of neointimal hyperplasia was significantly greater in the PEG-DLC-nitinol stent group (58.7±24.7%) than in the nitinol stent group (40.0±20.3%) (p = 0.01).

Conclusion: Our findings indicate that DLC-coated nitinol stents might induce less neointimal hyperplasia than conventional nitinol stents following implantation in a canine iliac artery model; however, the DLC-coated nitinol stent surface when reformed with PEG induces more neointimal hyperplasia than either a conventional or DLC-coated nitinol stent.

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Figures

Figure 1
Figure 1
Schematic drawings of the three stent types. (a) Uncoated nitinol stent. (b) Diamond-like carbon (DLC)-coated nitinol stent. (c) Polyethylene glycol (PEG)-DLC-coated nitinol stent. Si, silicon.
Figure 2
Figure 2
Stent placement procedure. (a) Stents (arrows) are placed in both iliac arteries. (b) Angiography immediately after stent placement (n = 4, two stents in each iliac artery) shows good position and expansions of the stents (arrows).
Figure 3
Figure 3
Percentage of neointimal hyperplasia in the three different stent groups. DLC, diamond-like carbon; PEG, polyethylene glycol.
Figure 4
Figure 4
Cross-sectional photomicrographs of representative serial pathology specimens from the three groups. Low microscopic findings (a–c) show that the neointimal hyperplasia area was significantly less in the diamond-like carbon (DLC)-coated stent (b) compared with that in the nitinol stent (a) and was greater in the polyethylene glycol (PEG)-DLC-coated stent (c) than in the nitinol stent. A high-power microscopic image (d) for the PEG stent (c) shows that a large portion of the neointimal hyperplasia was caused by the overproduction of collagen (arrows) secreted by proliferated fibroblasts. Arrowhead: stent strut.
See this image and copyright information in PMC

References

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