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Coronary bare metal stent implantation in homozygous LDL receptor deficient swine induces a neointimal formation pattern similar to humans. Atherosclerosis 2010; 213:518-24. [PMID: 20950808 DOI: 10.1016/j.atherosclerosis.2010.09.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 08/24/2010] [Accepted: 09/17/2010] [Indexed: 11/23/2022]
Abstract
INTRODUCTION To date, most of all new developments in stent technologies are tested in normal animals. Although invaluable in the evaluation of device safety, the juvenile domestic swine (DS) do not follow the biological healing response occurring in humans following coronary stent implantation. By using a novel swine breed afflicted with familial hypercholesterolemia (FHS), we aimed to analyse the vascular response occurring following bare metal stent (BMS) implantation by comparing in vivo endovascular imaging and histological data. METHODS A total of 26 swine were included in this study (12 FHS and 14 DS). Sixty eight BMS (FHS=28 versus DS=40) were implanted using a 10% overstretch ratio. Imaging evaluation (IVUS and OCT) was conducted in all animals at 30 (n=14) or 90 (n=12) days following stent implantation. After imaging, the stented coronary segments were harvested for histological evaluation. RESULTS At 30 days, the degree of neointimal formation analysed by OCT (%AS=DS 21.9 ± 10% versus FHS 25.4 ± 12%; p=0.18) and histology (DS 24.6 ± 10% versus FHS 23.58 ± 10%; p=0.8) was similar between both animal groups. At 90 days, the degree of neointimal formation in the DS group decreased in all analysed variables (-40% in IVUS neointimal volume, -57% in OCT %AS, and -30% in %AS by histology) compared to the progression of neointimal formation observed in the FHS group (+29% in IVUS neointimal volume, +27% in OCT %AS and +43% in %AS by histology). CONCLUSION The pattern of neointimal formation following BMS implantation in the FHS follows a progressive course that does not occur in the DS. Therefore, by providing a progressive neointimal biological response to BMS implantation, the FHS could serve as an ideal efficacy model for the validation of drug eluting stent technologies.
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Thim T, Hagensen MK, Wallace-Bradley D, Granada JF, Kaluza GL, Drouet L, Paaske WP, Bøtker HE, Falk E. Unreliable Assessment of Necrotic Core by Virtual Histology Intravascular Ultrasound in Porcine Coronary Artery Disease. Circ Cardiovasc Imaging 2010; 3:384-91. [PMID: 20460496 DOI: 10.1161/circimaging.109.919357] [Citation(s) in RCA: 191] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Troels Thim
- From The Atherosclerosis Research Unit (T.T., M.K.H., E.F.), Department of Cardiology, Aarhus University Hospital, Skejby and; Institute of Clinical Medicine, Aarhus University, Denmark; The Jack H. Skirball Center for Cardiovascular Research (T.T., D.W.-B., J.F.G., G.L.K.), Cardiovascular Research Foundation, New York, NY; Institut des Vaisseaux et du Sang (L.D.), Paris, France; and the Departments of Cardiothoracic and Vascular Surgery (W.P.P.), and Cardiology (H.E.B.), Aarhus University Hospital
| | - Mette Kallestrup Hagensen
- From The Atherosclerosis Research Unit (T.T., M.K.H., E.F.), Department of Cardiology, Aarhus University Hospital, Skejby and; Institute of Clinical Medicine, Aarhus University, Denmark; The Jack H. Skirball Center for Cardiovascular Research (T.T., D.W.-B., J.F.G., G.L.K.), Cardiovascular Research Foundation, New York, NY; Institut des Vaisseaux et du Sang (L.D.), Paris, France; and the Departments of Cardiothoracic and Vascular Surgery (W.P.P.), and Cardiology (H.E.B.), Aarhus University Hospital
| | - David Wallace-Bradley
- From The Atherosclerosis Research Unit (T.T., M.K.H., E.F.), Department of Cardiology, Aarhus University Hospital, Skejby and; Institute of Clinical Medicine, Aarhus University, Denmark; The Jack H. Skirball Center for Cardiovascular Research (T.T., D.W.-B., J.F.G., G.L.K.), Cardiovascular Research Foundation, New York, NY; Institut des Vaisseaux et du Sang (L.D.), Paris, France; and the Departments of Cardiothoracic and Vascular Surgery (W.P.P.), and Cardiology (H.E.B.), Aarhus University Hospital
| | - Juan F. Granada
- From The Atherosclerosis Research Unit (T.T., M.K.H., E.F.), Department of Cardiology, Aarhus University Hospital, Skejby and; Institute of Clinical Medicine, Aarhus University, Denmark; The Jack H. Skirball Center for Cardiovascular Research (T.T., D.W.-B., J.F.G., G.L.K.), Cardiovascular Research Foundation, New York, NY; Institut des Vaisseaux et du Sang (L.D.), Paris, France; and the Departments of Cardiothoracic and Vascular Surgery (W.P.P.), and Cardiology (H.E.B.), Aarhus University Hospital
| | - Greg L. Kaluza
- From The Atherosclerosis Research Unit (T.T., M.K.H., E.F.), Department of Cardiology, Aarhus University Hospital, Skejby and; Institute of Clinical Medicine, Aarhus University, Denmark; The Jack H. Skirball Center for Cardiovascular Research (T.T., D.W.-B., J.F.G., G.L.K.), Cardiovascular Research Foundation, New York, NY; Institut des Vaisseaux et du Sang (L.D.), Paris, France; and the Departments of Cardiothoracic and Vascular Surgery (W.P.P.), and Cardiology (H.E.B.), Aarhus University Hospital
| | - Ludovic Drouet
- From The Atherosclerosis Research Unit (T.T., M.K.H., E.F.), Department of Cardiology, Aarhus University Hospital, Skejby and; Institute of Clinical Medicine, Aarhus University, Denmark; The Jack H. Skirball Center for Cardiovascular Research (T.T., D.W.-B., J.F.G., G.L.K.), Cardiovascular Research Foundation, New York, NY; Institut des Vaisseaux et du Sang (L.D.), Paris, France; and the Departments of Cardiothoracic and Vascular Surgery (W.P.P.), and Cardiology (H.E.B.), Aarhus University Hospital
| | - William P. Paaske
- From The Atherosclerosis Research Unit (T.T., M.K.H., E.F.), Department of Cardiology, Aarhus University Hospital, Skejby and; Institute of Clinical Medicine, Aarhus University, Denmark; The Jack H. Skirball Center for Cardiovascular Research (T.T., D.W.-B., J.F.G., G.L.K.), Cardiovascular Research Foundation, New York, NY; Institut des Vaisseaux et du Sang (L.D.), Paris, France; and the Departments of Cardiothoracic and Vascular Surgery (W.P.P.), and Cardiology (H.E.B.), Aarhus University Hospital
| | - Hans Erik Bøtker
- From The Atherosclerosis Research Unit (T.T., M.K.H., E.F.), Department of Cardiology, Aarhus University Hospital, Skejby and; Institute of Clinical Medicine, Aarhus University, Denmark; The Jack H. Skirball Center for Cardiovascular Research (T.T., D.W.-B., J.F.G., G.L.K.), Cardiovascular Research Foundation, New York, NY; Institut des Vaisseaux et du Sang (L.D.), Paris, France; and the Departments of Cardiothoracic and Vascular Surgery (W.P.P.), and Cardiology (H.E.B.), Aarhus University Hospital
| | - Erling Falk
- From The Atherosclerosis Research Unit (T.T., M.K.H., E.F.), Department of Cardiology, Aarhus University Hospital, Skejby and; Institute of Clinical Medicine, Aarhus University, Denmark; The Jack H. Skirball Center for Cardiovascular Research (T.T., D.W.-B., J.F.G., G.L.K.), Cardiovascular Research Foundation, New York, NY; Institut des Vaisseaux et du Sang (L.D.), Paris, France; and the Departments of Cardiothoracic and Vascular Surgery (W.P.P.), and Cardiology (H.E.B.), Aarhus University Hospital
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