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Long-term endothelial dysfunction is more pronounced after stenting than after balloon angioplasty in porcine coronary arteries.

Abstract：

OBJECTIVE:To compare percutaneous transluminal coronary angioplasty (PTCA) and stent implantation with respect to the long-term changes they induce in the newly formed endothelium in porcine coronary arteries by studying both morphological and functional parameters of the endothelium at 2 weeks and 3 months after intervention. BACKGROUND:Problems affecting PTCA or stent implantation have been overcome to a large extent by means of better techniques and the availability of new drugs. Late problems, however, still exist in that restenosis affects a large number of patients. With an increasing number of patients being treated with stents, the problem of in-stent restenosis is of even greater concern, as this seems difficult to treat. A functional endothelial lining is thought to be important in controlling the growth of the underlying vascular tissue. We hypothesized that the enhanced neointimal hyperplasia observed after stenting is associated with a more pronounced and prolonged endothelial dysfunction. METHODS:Arteries were analyzed using a dye-exclusion test and planimetry of permeable areas. Thereafter, the arteries were processed for light and scanning electron microscopy for assessment of morphology and proliferative response. RESULTS:Leakage of the endothelium for molecules such as Evans blue-albumin as well as prolonged endothelial proliferation is observed as late as 3 months after the intervention, and is more pronounced after stenting. Permeability is associated with distinct morphologic characteristics: endothelial retraction, the expression of surface folds, and the adhesion of leukocytes. CONCLUSIONS:Stenting especially decreases long-term vascular integrity with respect to permeability and endothelial proliferation, and is associated with distinct morphologic characteristics.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

van Beusekom HM,Whelan DM,Hofma SH,Krabbendam SC,van Hinsbergh VW,Verdouw PD,van der Giessen WJ

doi

10.1016/s0735-1097(98)00348-9

subject

Has Abstract

pub_date

1998-10-01 00:00:00

pages

1109-17

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(98)00348-9

journal_volume

pub_type

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Long-term endothelial dysfunction is more pronounced after stenting than after balloon angioplasty in porcine coronary arteries.