Preview

Translational Medicine

Advanced search

A new domestic self-expanding nitinol stent: in vivo preclinical study

https://doi.org/10.18705/2311-4495-2024-11-5-445-455

EDN: FCFQGU

Abstract

Objective. To evaluate the results of implantation of a new domestic self-expanding nitinol stent in experimental animals. Materials and methods. Experimental implantations of a self-expanding nitinol stent were performed in the common iliac artery of three Vietnamese Pot-bellied pigs. In the postoperative period, all animals received dual antiplatelet therapy for 3 months. Vital signs were also assessed throughout the observation period. After 3 months, the animals underwent control angiography and ultrasound examination of the iliofemoral segment, followed by withdrawal from the experiment by euthanasia. The next step was a macroscopic and histological analysis of the stented areas of the vessels. Results. The observation period of the animals was 3 months. Throughout the entire observation period, vital signs in all animals remained within normal values. The results of control angiography and ultrasound examination after 3 months demonstrated patency, as well as the absence of significant in-stent stenoses in two pigs. One animal showed signs of in-stent restenosis. The results of macroscopic and histological analysis showed signs of damage to the subendothelial layer, as well as myointimal hyperplasia. These changes were especially pronounced in the animal with restenosis. Our analysis showed that the presented results were due to excessive oversizing of the implanted stents (20–30 %). Conclusion. Our proposed self-expanding nitinol stent, in general, showed satisfactory results in the in vivo experiment. Nevertheless, it should be borne in mind that severe stent oversizing can cause excessive neointimal proliferation, which, in turn, will lead to the development of restenosis in the long-term postoperative period. In this regard, it is necessary to carry out an additional series of implantation of the presented stent to the experimental animals with less oversizing in order to determine its optimal values for this particular stent model.

About the Authors

E. V. Verkhovskaya
Almazov National Medical Research Centre
Russian Federation

Ekaterina V. Verkhovskaya, resident, Department of Cardiovascular Surgery

Saint Petersburg


Competing Interests:

The authors declare no conflict of interest.



A. G. Vanyurkin
Almazov National Medical Research Centre
Russian Federation

Almaz G. Vanyurkin, junior researcher, Research Institute of Vascular and Interventional Surgery, cardiovascular surgeon, Department of Cardiovascular Surgery No. 2

Akkuratova str., 2, Saint Petersburg, 197341


Competing Interests:

The authors declare no conflict of interest.



Yu. K. Panteleeva
Almazov National Medical Research Centre
Russian Federation

Yulia K. Panteleeva, junior researcher, Research Institute of Vascular and Interventional Surgery, cardiovascular surgeon, Department of Cardiovascular Surgery No. 2

Saint Petersburg


Competing Interests:

The authors declare no conflict of interest.



E. O. Poplavsky
Almazov National Medical Research Centre
Russian Federation

Evgeny O. Poplavsky, resident, Department of Cardiovascular Surgery

Saint Petersburg


Competing Interests:

The authors declare no conflict of interest.



E. V. Tsvetkova
Almazov National Medical Research Centre
Russian Federation

Elena V. Tsvetkova, researcher, Research Institute of Vascular and Interventional Surgery, endocrinologist

Saint Petersburg


Competing Interests:

The authors declare no conflict of interest.



S. A. Samuylovskaya
Almazov National Medical Research Centre
Russian Federation

Sofia A. Samuylovskaya, laboratory research assistant, Research Institute of Vascular and Interventional Surgery, cardiologist

Saint Petersburg


Competing Interests:

The authors declare no conflict of interest.



S. V. Kogay
Almazov National Medical Research Centre
Russian Federation

Sergey V. Kogay, cardiologist, Department of Cardiovascular Surgery No. 2

Saint Petersburg


Competing Interests:

The authors declare no conflict of interest.



A. S. Evdokimov
Closed Joint Stock Company Scientific and Production Enterprise “MedInj”
Russian Federation

Alexander S. Evdokimov, General Director of MedInj Scientific and Production Enterprise

Penza


Competing Interests:

The authors declare no conflict of interest.



S. V. Evdokimov
Closed Joint Stock Company Scientific and Production Enterprise “MedInj”
Russian Federation

Sergey V. Evdokimov, Managing Director of MedInj Scientific and Production Enterprise

Penza


Competing Interests:

The authors declare no conflict of interest.



M. A. Chernyavsky
Almazov National Medical Research Centre
Russian Federation

Mikhail A. Chernyavsky, D.M.Sc., Head of the Research Institute of Vascular and Interventional Surgery

Saint Petersburg


Competing Interests:

The authors declare no conflict of interest.



References

1. Writing Committee Members; Gornik HL, Aronow HD, Goodney PP, et al. 2024 ACC/AHA/AACVPR/APMA/ ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/ American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2024; 83:24:2497– 2604. DOI: 10.1016/j.jacc.2024.02.013.

2. Gavrilenko AV, Egorov AA, Kotov AE, et al. Surgical treatment of patients with atherosclerotic occlusion of the aortoiliac segment combined with distal-bed lesions. Angiol Sosud Khir. 2012; 18:3:101–5. In Russian

3. Tang QH, Chen J, Hu CF, et al. Comparison Between Endovascular and Open Surgery for the Treatment of Peripheral Artery Diseases: A Meta-Analysis. Ann Vasc Surg. 2020; 62:484–495. DOI: 10.1016/j.avsg.2019.06.039.

4. Duda SH, Bosiers M, Lammer J, et al. Drug-eluting and bare nitinol stents for the treatment of atherosclerotic lesions in the superficial femoral artery: long-term results from the SIROCCO trial. J Endovasc Ther. 2006; 13:6:701–10. DOI: 10.1583/05-1704.1.

5. Maleckis K, Deegan P, Poulson W, et al. Comparison of femoropopliteal artery stents under axial and radial compression, axial tension, bending, and torsion deformations. J Mech Behav Biomed Mater. 2017; 75:160– 168. DOI: 10.1016/j.jmbbm.2017.07.017.

6. Maleckis K, Anttila E, Aylward P, et al. Nitinol Stents in the Femoropopliteal Artery: A Mechanical Perspective on Material, Design, and Performance. Ann Biomed Eng. 2018; 46:5:684–704. DOI: 10.1007/s10439-018-1990-1.

7. Jeshari S, Die Loucou J, Leboffe M, et al. Preoperative Sizing to Lower In-Stent Restenosis in Peripheral Arterial Occlusive Disease. Ann Vasc Surg. 2024; 106:37–50. DOI: 10.1016/j.avsg.2024.02.017.

8. Zhao HQ, Nikanorov A, Virmani R, et al. Late stent expansion and neointimal proliferation of oversized Nitinol stents in peripheral arteries. Cardiovasc Intervent Radiol. 2009; 32:4:720–6. DOI: 10.1007/s00270-009-9601-z.

9. Saguner AM, Traupe T, Räber L, et al. Oversizing and restenosis with self-expanding stents in iliofemoral arteries. Cardiovasc Intervent Radiol. 2012; 35:4:906–13. DOI: 10.1007/s00270-011-0275-y.

10. Yamaguchi M, Sugimoto K, Zamora CA, et al. Placement of self-expanding stents with different diameters in the porcine venous system: an experimental study. J Vasc Interv Radiol. 2006; 17:1:113–9. DOI: 10.1097/01.RVI.0000186951.22050.3D.

11. Bernini M, Colombo M, Dunlop C, et al. Oversizing of self-expanding Nitinol vascular stents A biomechanical investigation in the superficial femoral artery. J Mech Behav Biomed Mater. 2022; 132:105259. DOI: 10.1016/j.jmbbm.2022.105259.

12. Li H, Rha SW, Choi BG, et al. Impact of chronic outward force on arterial responses of proximal and distal of long superficial femoral artery stent. BMC Cardiovasc Disord. 2021;21(1):323. DOI: 10.1186/s12872-021-02141-z.


Review

For citations:


Verkhovskaya E.V., Vanyurkin A.G., Panteleeva Yu.K., Poplavsky E.O., Tsvetkova E.V., Samuylovskaya S.A., Kogay S.V., Evdokimov A.S., Evdokimov S.V., Chernyavsky M.A. A new domestic self-expanding nitinol stent: in vivo preclinical study. Translational Medicine. 2024;11(5):445-455. (In Russ.) https://doi.org/10.18705/2311-4495-2024-11-5-445-455. EDN: FCFQGU

Views: 252


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2311-4495 (Print)
ISSN 2410-5155 (Online)