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Pineda-Castillo SA, Acar H, Detamore MS, Holzapfel GA, Lee CH. Modulation of Smooth Muscle Cell Phenotype for Translation of Tissue-Engineered Vascular Grafts. TISSUE ENGINEERING. PART B, REVIEWS 2023; 29:574-588. [PMID: 37166394 PMCID: PMC10618830 DOI: 10.1089/ten.teb.2023.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/25/2023] [Indexed: 05/12/2023]
Abstract
Translation of small-diameter tissue-engineered vascular grafts (TEVGs) for the treatment of coronary artery disease (CAD) remains an unfulfilled promise. This is largely due to the limited integration of TEVGs into the native vascular wall-a process hampered by the insufficient smooth muscle cell (SMC) infiltration and extracellular matrix deposition, and low vasoactivity. These processes can be promoted through the judicious modulation of the SMC toward a synthetic phenotype to promote remodeling and vascular integration; however, the expression of synthetic markers is often accompanied by a decrease in the expression of contractile proteins. Therefore, techniques that can precisely modulate the SMC phenotypical behavior could have the potential to advance the translation of TEVGs. In this review, we describe the phenotypic diversity of SMCs and the different environmental cues that allow the modulation of SMC gene expression. Furthermore, we describe the emerging biomaterial approaches to modulate the SMC phenotype in TEVG design and discuss the limitations of current techniques. In addition, we found that current studies in tissue engineering limit the analysis of the SMC phenotype to a few markers, which are often the characteristic of early differentiation only. This limited scope has reduced the potential of tissue engineering to modulate the SMC toward specific behaviors and applications. Therefore, we recommend using the techniques presented in this review, in addition to modern single-cell proteomics analysis techniques to comprehensively characterize the phenotypic modulation of SMCs. Expanding the holistic potential of SMC modulation presents a great opportunity to advance the translation of living conduits for CAD therapeutics.
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Affiliation(s)
- Sergio A. Pineda-Castillo
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, Oklahoma, USA
- Stephenson School of Biomedical Engineering, The University of Oklahoma, Norman, Oklahoma, USA
| | - Handan Acar
- Stephenson School of Biomedical Engineering, The University of Oklahoma, Norman, Oklahoma, USA
- Institute for Biomedical Engineering, Science and Technology, The University of Oklahoma, Norman, Oklahoma, USA
| | - Michael S. Detamore
- Stephenson School of Biomedical Engineering, The University of Oklahoma, Norman, Oklahoma, USA
- Institute for Biomedical Engineering, Science and Technology, The University of Oklahoma, Norman, Oklahoma, USA
| | - Gerhard A. Holzapfel
- Institute of Biomechanics, Graz University of Technology, Graz, Austria
- Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Chung-Hao Lee
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, Oklahoma, USA
- Institute for Biomedical Engineering, Science and Technology, The University of Oklahoma, Norman, Oklahoma, USA
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Díaz-Flores L, Gutiérrez R, García MP, González-Gómez M, Díaz-Flores L, Gayoso S, Carrasco JL, Álvarez-Argüelles H. Ultrastructural Study of Platelet Behavior and Interrelationship in Sprouting and Intussusceptive Angiogenesis during Arterial Intimal Thickening Formation. Int J Mol Sci 2021; 22:ijms222313001. [PMID: 34884806 PMCID: PMC8657547 DOI: 10.3390/ijms222313001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/23/2021] [Accepted: 11/29/2021] [Indexed: 12/13/2022] Open
Abstract
Platelets in atherosclerosis, bypass stenosis, and restenosis have been extensively assessed. However, a sequential ultrastructural study of platelets in angiogenesis during the early phases of these lesions has received less attention. Our objective was the study of platelets in angiogenesis and vessel regression during intimal thickening (IT) formation, a precursor process of these occlusive vascular diseases. For this purpose, we used an experimental model of rat occluded arteries and procedures for ultrastructural observation. The results show (a) the absence of platelet adhesion in the de-endothelialized occluded arterial segment isolated from the circulation, (b) that intraarterial myriad platelets contributed from neovessels originated by sprouting angiogenesis from the periarterial microvasculature, (c) the association of platelets with blood components (fibrin, neutrophils, macrophages, and eosinophils) and non-polarized endothelial cells (ECs) forming aggregates (spheroids) in the arterial lumen, (d) the establishment of peg-and-socket junctions between platelets and polarized Ecs during intussusceptive angiogenesis originated from the EC aggregates, with the initial formation of IT, and (e) the aggregation of platelets in regressing neovessels (‘transitory paracrine organoid’) and IT increases. In conclusion, in sprouting and intussusceptive angiogenesis and vessel regression during IT formation, we contribute sequential ultrastructural findings on platelet behavior and relationships, which can be the basis for further studies using other procedures.
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Affiliation(s)
- Lucio Díaz-Flores
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
- Correspondence: ; Tel.: +34-922-319317; Fax: +34-922-319279
| | - Ricardo Gutiérrez
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
| | - Maria Pino García
- Department of Pathology, Eurofins Megalab–Hospiten Hospitals, 38100 Tenerife, Spain;
| | - Miriam González-Gómez
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
- Instituto de Tecnologías Biomédicas de Canarias, University of La Laguna, 38071 Tenerife, Spain
| | - Lucio Díaz-Flores
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
| | - Sara Gayoso
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
| | - Jose Luis Carrasco
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
| | - Hugo Álvarez-Argüelles
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
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3
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Colussi G, Zuttion F, Bais B, Dolso P, Valente M, Gigli GL, Gasparini D, Sponza M, Catena C, Sechi LA, Cavarape A. Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study. J Clin Med 2018; 7:E286. [PMID: 30227674 PMCID: PMC6162515 DOI: 10.3390/jcm7090286] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/09/2018] [Accepted: 09/12/2018] [Indexed: 11/28/2022] Open
Abstract
Carotid artery stenting (CAS) is a minimal invasive procedure used to resolve carotid occlusion that can be affected by peri-procedural complications. Statin use before CAS has shown to reduce peri-procedural risk and improve survival, though time-dependent cofactors that influence mortality has not been considered. The aim of this study was to evaluate long-term survival of patients who undergo CAS considering new occurred major adverse cardiovascular event (MACE) as time-dependent cofactor. In this study, 171 high cardiovascular risk patients (age 72 ± 8 years, 125 males) were enrolled after CAS procedure and were followed for a median of 8.4 years. Death occurred in 44% of patients with a mean time to death of 69 ± 39 months and MACE in 34% with a mean time of 35 ± 42 months. In patients who used or not statins at baseline, death occurred in 33% and 65%, respectively (p < 0.001). Survival analysis showed that statin use reduced risk of death (hazard ratio HR 0.36, 95% confidence interval CI 0.23⁻0.58, p < 0.0001). Including MACE as time-dependent variable did not change beneficial effects of statins. Additionally, statin use was associated with a protective effect on MACE (HR 0.48, 95% CI 0.27⁻0.85, p = 0.012); particularly, the prevalence of stroke was reduced by 59% (p = 0.018). In multivariate analysis, effects of statins were independent of demographic and anthropometric variables, prevalence of cardiovascular risk factors, renal function, antiplatelet use, and MACE occurrence. In conclusion, use of statins before CAS procedure is associated with increased long-term survival and reduced MACE occurrence. This evidence supports the hypothesis that statin use before CAS might be beneficial in high risk patients.
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Affiliation(s)
- GianLuca Colussi
- Division of Internal Medicine, Department of Medicine, University of Udine, 33100 Udine, Italy.
| | - Francesca Zuttion
- Division of Internal Medicine, Department of Medicine, University of Udine, 33100 Udine, Italy.
| | - Bruno Bais
- Division of Internal Medicine, Department of Medicine, University of Udine, 33100 Udine, Italy.
| | - Pierluigi Dolso
- Division of Neurology, Department of Medicine, University of Udine, 33100 Udine, Italy.
| | - Mariarosaria Valente
- Division of Neurology, Department of Medicine, University of Udine, 33100 Udine, Italy.
| | - Gian Luigi Gigli
- Division of Neurology, Department of Medicine, University of Udine, 33100 Udine, Italy.
| | - Daniele Gasparini
- Division of Interventional Radiology, Department of Radiology, Academic Hospital of Udine, 33100 Udine, Italy.
| | - Massimo Sponza
- Division of Interventional Radiology, Department of Radiology, Academic Hospital of Udine, 33100 Udine, Italy.
| | - Cristiana Catena
- Division of Internal Medicine, Department of Medicine, University of Udine, 33100 Udine, Italy.
| | - Leonardo A Sechi
- Division of Internal Medicine, Department of Medicine, University of Udine, 33100 Udine, Italy.
| | - Alessandro Cavarape
- Division of Internal Medicine, Department of Medicine, University of Udine, 33100 Udine, Italy.
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Hong JH, Sohn SI, Kwak J, Yoo J, Chang HW, Kwon OK, Jung C, Chung I, Bae HJ, Lee JS, Han MK. Dose-Dependent Effect of Statin Pretreatment on Preventing the Periprocedural Complications of Carotid Artery Stenting. Stroke 2017. [PMID: 28626049 DOI: 10.1161/strokeaha.117.016680] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE We investigated whether statin pretreatment can dose dependently reduce periprocedural complications in patients undergoing carotid artery stenting because of symptomatic carotid artery stenosis. METHODS We enrolled a consecutive series of 397 symptomatic carotid artery stenosis (≥50% stenosis on conventional angiography) treated with carotid artery stenting at 2 tertiary university hospitals over a decade. Definition of periprocedural complications included any stroke, myocardial infarction, and death within 1 month after or during the procedure. Statin pretreatment was divided into 3 categories according to the atorvastatin equivalent dose: none (n=158; 39.8%), standard dose (<40 mg of atorvastatin, n=155; 39.0%), and high dose (≥40 mg; n=84; 21.2%). A multivariable logistic regression analysis with the generalized estimating equation method was used to investigate independent factors in periprocedural complications. RESULTS The patients' mean age was 68.7 years (81.6% men). The periprocedural complication rates across the 3 categories of statin use were 12.0%, 4.5%, and 1.2%. After adjustment, a change in the atorvastatin dose category was associated with reduction in the odds of periprocedural complications for each change in dose category (standard-dose statin: odds ratio, 0.24; 95% confidence interval, 0.07-0.81; high-dose statin: odds ratio, 0.11; 95% confidence interval, 0.01-0.96; P for trend=0.01). Administration of antiplatelet drugs was also an independent factor in periprocedural complications (OR, 0.18; 95% CI, 0.05-0.69). CONCLUSIONS This study shows that statin pretreatment may reduce the incidence of periprocedural complications dose dependently in patients with symptomatic carotid artery stenting.
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Affiliation(s)
- Jeong-Ho Hong
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - Sung-Il Sohn
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - Jaehyuk Kwak
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - Joonsang Yoo
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - Hyuk Won Chang
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - O-Ki Kwon
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - Cheolkyu Jung
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - Inyoung Chung
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - Hee-Joon Bae
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - Ji Sung Lee
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.)
| | - Moon-Ku Han
- From the Department of Neurology (J.-H.H., S.-I.S., J.K., J.Y.); Department of Radiology (H.W.C.), Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea; Department of Neurology (I.C., H.-J.B., M.-K.H.), Department of Neurosurgery (O.-K.K.), and Department of Radiology (C.J.), Seoul National University Bundang Hospital, Seongnam, Korea; and Clinical Trial Center, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea (J.S.L.).
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Abstract
Atherosclerosis is a silent chronic vascular pathology that is the cause of the majority of cardiovascular ischaemic events. The evolution of vascular disease involves a combination of endothelial dysfunction, extensive lipid deposition in the intima, exacerbated innate and adaptive immune responses, proliferation of vascular smooth muscle cells and remodelling of the extracellular matrix, resulting in the formation of an atherosclerotic plaque. High-risk plaques have a large acellular lipid-rich necrotic core with an overlying thin fibrous cap infiltrated by inflammatory cells and diffuse calcification. The formation of new fragile and leaky vessels that invade the expanding intima contributes to enlarge the necrotic core increasing the vulnerability of the plaque. In addition, biomechanical, haemodynamic and physical factors contribute to plaque destabilization. Upon erosion or rupture, these high-risk lipid-rich vulnerable plaques expose vascular structures or necrotic core components to the circulation, which causes the activation of tissue factor and the subsequent formation of a fibrin monolayer (coagulation cascade) and, concomitantly, the recruitment of circulating platelets and inflammatory cells. The interaction between exposed atherosclerotic plaque components, platelet receptors and coagulation factors eventually leads to platelet activation, aggregation and the subsequent formation of a superimposed thrombus (i.e. atherothrombosis) which may compromise the arterial lumen leading to the presentation of acute ischaemic syndromes. In this review, we will describe the progression of the atherosclerotic lesion along with the main morphological characteristics that predispose to plaque rupture, and discuss the multifaceted mechanisms that drive platelet activation and subsequent thrombus formation. Finally, we will consider the current scientific challenges and future research directions.
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Affiliation(s)
- L Badimon
- Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain; Cardiovascular Research Chair, UAB, Barcelona, Spain
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6
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Combining cell sheet technology and electrospun scaffolding for engineered tubular, aligned, and contractile blood vessels. Biomaterials 2014; 35:2713-9. [DOI: 10.1016/j.biomaterials.2013.12.035] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 12/13/2013] [Indexed: 12/20/2022]
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Melfi R, Patti G, Di Sciascio G. The protective effect of clopidogrel and atorvastatin in patients undergoing carotid stenting. Interv Cardiol 2013. [DOI: 10.2217/ica.13.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Lazzaro MA, Teleb MS, Zaidat OO. Angiographic lumen changes associated with oversized intracranial stent implantation for aneurysm treatment. J Neuroimaging 2013; 23:508-13. [PMID: 23746166 DOI: 10.1111/jon.12034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 02/08/2013] [Accepted: 03/03/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The effect of oversized intracranial stent implantation, and potential excessive neointimal hyperplasia from the chronic outward radial force, has not been reported. We sought to compare the angiographic narrowing associated with implantation of oversized stents. METHODS We reviewed an aneurysm database and identified patients treated with stent-assisted embolization involving a vessel size transition. Demographics and lesion characteristics were extracted. The relationship between lumen diameter and stent oversizing was compared. RESULTS Twenty vessels were identified in 18 patients, providing 80 paired data points. Mean follow-up time was 8 months (SD 6). The average oversizing in the smaller diameter parent vessel landing-zone was 1.75 mm. Mean change in lumen size from pre-stent implantation was not significantly different for any of the four sites. There was a significant difference in change of lumen size at the stent tines when compared with the respective mid-stent segment for both the proximal (P = 0.02) and distal (P = 0.0004) landing zones. CONCLUSIONS A small significant lumen loss occurs at stent tines when compared to midstent struts. However, there is no overall significant stenosis from highly oversized stents. Persistent luminal gain from the oversized stent radial force likely predominates over any neointimal hyperplasia.
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Affiliation(s)
- Marc A Lazzaro
- Medical College of Wisconsin/Froedtert Hospital, Department of Neurology, 9200 West Wisconsin Avenue, Milwaukee, WI; Medical College of Wisconsin/Froedtert Hospital, Department of Neurosurgery, 9200 West Wisconsin Avenue, Milwaukee, WI
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Malle C, Tada T, Steigerwald K, Ughi GJ, Schuster T, Nakano M, Massberg S, Jehle J, Guagliumi G, Kastrati A, Virmani R, Byrne RA, Joner M. Tissue Characterization After Drug-Eluting Stent Implantation Using Optical Coherence Tomography. Arterioscler Thromb Vasc Biol 2013; 33:1376-83. [DOI: 10.1161/atvbaha.113.301227] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Caroline Malle
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Tomohisa Tada
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Kristin Steigerwald
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Giovanni J. Ughi
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Tibor Schuster
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Masataka Nakano
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Steffen Massberg
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Johannes Jehle
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Giulio Guagliumi
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Adnan Kastrati
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Renu Virmani
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Robert A. Byrne
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
| | - Michael Joner
- From the Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany (C.M., T.T., K.S., T.S., S.M., J.J., A.K., R.A.B., M.J.); Department of Cardiovascular Diseases, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (G.J.U.); Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein (J.J.); Cardiovascular Department, Division of Cardiology, Ospedali Riuniti di Bergamo, Bergamo, Italy (G.G.); and CVPath Institute Inc,
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10
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Hwang JM, Wu CH, Kuo WW, Jong GP, Lai CH, Tsai CH, Tsai FJ, Chang MH, Wu JP, Huang CY. Pro-inflammation and pro-fibrosis factors were highly induction in heart tissues of carotid arteries balloon-injured animal model. Cell Biochem Funct 2012; 30:390-4. [PMID: 22411094 DOI: 10.1002/cbf.2805] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 11/18/2011] [Accepted: 12/30/2011] [Indexed: 11/07/2022]
Affiliation(s)
| | - Chieh-His Wu
- Department of Biological Science and Technology; China Medical University; Taichung; Taiwan
| | - Wei-Wen Kuo
- Department of Biological Science and Technology; China Medical University; Taichung; Taiwan
| | - Gwo-Ping Jong
- Division of Cardiology, Department of Internal Medicine; Armed Force Taichung General Hospital; Taichung; Taiwan
| | - Chao-Hung Lai
- Division of Cardiology, Department of Internal Medicine; Armed Force Taichung General Hospital; Taichung; Taiwan
| | - Chang-Hai Tsai
- Department of Healthcare Administration; Asia University; Taichung; Taiwan
| | - Fuu-Jen Tsai
- Graduate Institute of Chinese Medical Science; China Medical University; Taichung; Taiwan
| | | | - Jia-Ping Wu
- Graduate Institute of Basic Medical Science; China Medical University; Taichung; Taiwan
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11
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Inhibitory effects of OD 78 [3-(4-bromo-phenoxy)-4,5-dihydroxybenzoic acid-methyl ester] on the proliferation and migration of TNF-α-induced rat aortic smooth muscle cells. Arch Pharm Res 2011; 34:1191-9. [DOI: 10.1007/s12272-011-0718-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 03/21/2011] [Accepted: 03/29/2011] [Indexed: 10/17/2022]
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12
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Verzini F, De Rango P, Parlani G, Giordano G, Caso V, Cieri E, Isernia G, Cao P. Effects of statins on early and late results of carotid stenting. J Vasc Surg 2011; 53:71-9; discussion 79. [DOI: 10.1016/j.jvs.2010.08.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 08/06/2010] [Accepted: 08/10/2010] [Indexed: 10/18/2022]
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13
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Tharp DL, Masseau I, Ivey J, Ganjam VK, Bowles DK. Endogenous testosterone attenuates neointima formation after moderate coronary balloon injury in male swine. Cardiovasc Res 2009; 82:152-60. [PMID: 19181935 PMCID: PMC2652742 DOI: 10.1093/cvr/cvp038] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 12/28/2008] [Accepted: 01/28/2009] [Indexed: 12/21/2022] Open
Abstract
AIMS Previous studies from our laboratory have demonstrated that testosterone increases coronary smooth muscle protein kinase C delta (PKC delta) both in vivo and in vitro and inhibits coronary smooth muscle proliferation by inducing G(0)/G(1) cell cycle arrest in a PKC delta-dependent manner. The purpose of the present study was to determine whether endogenous testosterone limits coronary neointima (NI) formation in a porcine model of post-angioplasty restenosis. METHODS AND RESULTS Sexually mature, male Yucatan miniature swine were either left intact (IM), castrated (CM), or castrated with testosterone replacement (CMT; Androgel, 10 mg/day). Angioplasty was performed in both the left anterior descending and left circumflex coronary arteries with balloon catheter overinflation to induce either moderate (1.25-1.3 x diameter; 3 x 30 s) or severe (1.4x diameter; 3 x 30 s) injury, and animals were allowed to recover for either 10 or 28 days. Injured coronary sections were dissected, fixed, stained (Verheoff-Van Gieson, Ki67, PKC delta, p27), and analysed. Vessels without internal elastic laminal rupture were excluded. Following moderate injury, intimal area, intima-to-media ratio (I/M), and I/M normalized to rupture index (RI) were increased in CM compared with IM and CMT. RI, medial area, and intimal/medial thickness (IMT) were not different between groups. NI formation was inversely related to serum testosterone concentration. Conversely, following severe injury, there were no significant differences between the groups. Testosterone inhibited proliferation and stimulated PKC delta and p27(kip1) expression during NI formation (10 days post-injury). CONCLUSION These findings demonstrate that endogenous testosterone limits coronary NI formation in male swine and provides support for a protective role for testosterone in coronary vasculoproliferative diseases, such as restenosis and atherosclerosis.
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Affiliation(s)
- Darla L. Tharp
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Isabelle Masseau
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Jan Ivey
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA
- Research Cath Laboratory, Center for Gender Physiology and Environmental Adaptation, University of Missouri, Columbia, MO, USA
| | - Venkataseshu K. Ganjam
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA
- Research Cath Laboratory, Center for Gender Physiology and Environmental Adaptation, University of Missouri, Columbia, MO, USA
| | - Douglas K. Bowles
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA
- Research Cath Laboratory, Center for Gender Physiology and Environmental Adaptation, University of Missouri, Columbia, MO, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA
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14
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Olofsson PS, Söderström LÅ, Jern C, Sirsjö A, Ria M, Sundler E, de Faire U, Wiklund PG, Öhrvik J, Hedin U, Paulsson-Berne G, Hamsten A, Eriksson P, Hansson GK. Genetic variants of TNFSF4 and risk for carotid artery disease and stroke. J Mol Med (Berl) 2008; 87:337-46. [DOI: 10.1007/s00109-008-0412-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 09/19/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
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15
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Alessi A, França Neto OR, Brofman PRS, Prim C, Noronha L, Silva RFKC, Baroncini LAV, Précoma DB. Use of rosiglitazone before and after vascular injury in hypercholesterolemic rabbits: Assessment of neointimal formation. Thromb J 2008; 6:12. [PMID: 18752684 PMCID: PMC2538502 DOI: 10.1186/1477-9560-6-12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Accepted: 08/27/2008] [Indexed: 01/12/2023] Open
Abstract
Objectives To analyse the effects of rosiglitazone administered at different times on neointimal formation in hypercholesterolemic rabbits following vascular injury. Methods Thirty-nine rabbits on a hypercholesterolemic diet were included. The animals underwent balloon catheter injury to the right iliac artery on day 14. They were divided into three groups as follows: control group, 13 rabbits without rosiglitazone; group I, 13 rabbits treated with rosiglitazone (3 mg/Kg body weight/day) for 28 days after the vascular injury; and group II, 13 rabbits treated with rosiglitazone (3 mg/Kg body weight/day) during all the experiment (42 days). Histological analysis was done by an experienced pathologist who was unaware of the rosiglitazone treatment. Histomorphometric parameters were performed by calculation of the luminal and intimal layer area, and intima/media layer area ratio (the area of the intimal layer divided by the area of the medial layer). Results Intimal area was significantly lower in group II vs. CG (p = 0.024) and group I (p = 0.006). Luminal layer area was higher in group II vs. CG (p < 0.0001) and group I (p < 0.0001). Intima/media layer area ratio was equal between CG and group I. Intima/media layer ratio area was significantly lower in group II vs. control group (p < 0.021) and group I (p < 0.003). There was a significant reduction of 65% and 71% in intima/media layer area ratio in group II vs. control group and group I, respectively. Conclusion Pretreatment with rosiglitazone in hypercholesterolemic rabbits submitted to vascular injury significantly reduces neointimal formation.
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Affiliation(s)
- Alexandre Alessi
- Center of Health and Biological Sciences, Pontifical Catholic University of Paraná, Brazil.
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16
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Horstick G, Bierbach B, Schlindwein P, Abegunewardene N, Vosseler M, Bittinger F, Becker D, Lauterbach M, Lehr HA, Kempski O. Resistance of the Internal Mammary Artery to Restenosis: A Histomorphologic Study of Various Porcine Arteries. J Vasc Res 2007; 45:45-53. [PMID: 17901706 DOI: 10.1159/000109076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2007] [Accepted: 05/16/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Restenosis after percutaneous transluminal angioplasty (PTA) of the internal mammary artery (IMA) grafts is much less pronounced than in other arteries and venous grafts. The aim of the study was to test whether various arteries respond differently to dilatation. METHODS PTA of the IMA, carotid, renal and circumflex coronary (RCx) arteries was performed in 9 pigs (balloon to artery ratio of 1:1.5). After 8 weeks, angiography was repeated and vessels prepared for histological analysis. Immunohistochemical staining was done to examine proliferative activity (Ki67) and to identify the vasa vasorum of the adventitia (F VIII-RA). RESULTS The intima-media ratio after PTA was lowest in the IMA (0.06), followed by the carotid (0.27) and renal arteries (0.49) and the RCx (0.69). Proliferation of the intima was seen at 287 degrees of the vessel circumference in the RCx, at 286 degrees in the renal and at 166 degrees in the carotid artery. No proliferative activity was seen in the IMA. The intima-adventitia ratio was lower in the IMA than in the RCx and renal arteries (p < 0.05). CONCLUSION Intima proliferation after PTA varies between the different vessels, with best results seen in the IMA. There are differences in remodeling after PTA between muscular, muscular/elastic and elastic arteries.
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Affiliation(s)
- Georg Horstick
- 2nd Medical Clinic, Johannes Gutenberg University, Mainz, Germany.
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17
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Abstract
The origins of vascular smooth muscle are far more diverse than previously thought. Lineage mapping studies show that the segmental organization of early vertebrate embryos leaves footprints on the adult vascular system in the form of a mosaic pattern of different smooth muscle types. Moreover, evolutionarily conserved tissue forming pathways produce vascular smooth muscle from a variety of unanticipated sources. A closer look at the diversity of smooth muscle origins in vascular development provides new perspectives about how blood vessels differ from one another and why they respond in disparate ways to common risk factors associated with vascular disease. The origins of vascular smooth muscle are far more diverse than previously thought. A closer look at the diversity of smooth muscle origins in vascular development provides new perspectives about how blood vessels differ from one another and why they respond in disparate ways to common risk factors associated with vascular disease.
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Affiliation(s)
- Mark W Majesky
- Department of Medicine, Carolina Cardiovascular Biology Center, University of North Carolina, Chapel Hill, NC 27599-7126, USA.
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18
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Gröschel K, Ernemann U, Schulz JB, Nägele T, Terborg C, Kastrup A. Statin Therapy at Carotid Angioplasty and Stent Placement: Effect on Procedure-related Stroke, Myocardial Infarction, and Death. Radiology 2006; 240:145-51. [PMID: 16793975 DOI: 10.1148/radiol.2401050603] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To retrospectively determine if preprocedural statin treatment is associated with a reduction of cardiovascular events after carotid angioplasty and stent placement (CAS) in patients with symptomatic carotid stenosis. MATERIALS AND METHODS A study resulting in a prospective database was approved by the institutional ethics review board; written informed consent was obtained. The approval and informed consent included future retrospective analysis. Consecutive patients (n = 180) from the prospective database underwent CAS for high-grade symptomatic carotid disease. The frequency of cardiovascular complications (composite of stroke, myocardial infarction, and death within 30 days after CAS) between 127 patients without preprocedural statin treatment and that of 53 patients with preprocedural statin treatment at CAS were compared with chi2 and multivariate logistic regression analysis. RESULTS The overall 30-day myocardial infarction rate was two of 180 (1%) patients, the minor stroke rate was 16 of 180 (9%) patients, the major stroke rate was one of 180 (0.5%) patients, and the death rate was two of 180 (1%) patients. The incidence of cardiovascular events (composite of stroke, myocardial infarction, and death within 30 days after CAS) was significantly different between patients with preprocedural treatment (4%) and those without preprocedural statin treatment (15%) (P < .05). These higher complication rates among patients without preprocedural statin treatment were not mediated by adjustment for age, sex, other baseline characteristics, degree of carotid stenosis, use of cerebral protection devices, or the year in which CAS was performed. CONCLUSION Preprocedural statin therapy appears to reduce the incidence of stroke, myocardial infarction, and death within 30 days after CAS. Future prospective randomized trials are warranted to further assess this potential protective effect of statin drugs during carotid interventions.
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Affiliation(s)
- Klaus Gröschel
- Department of Neurology, University of Tübingen, Tübingen, Germany
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19
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Krueger KD, Mitra AK, DelCore MG, Hunter WJ, Agrawal DK. A comparison of stent-induced stenosis in coronary and peripheral arteries. J Clin Pathol 2006; 59:575-9. [PMID: 16473929 PMCID: PMC1860405 DOI: 10.1136/jcp.2004.025643] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVES Restenosis is a complication of interventional procedures such as angioplasty and stenting, often limiting the success of these procedures. Knowledge regarding the relative behaviour of different arteries after these procedures is limited, despite the extensive use of different vascular models. Although the results from studies using different vessels are analysed to predict the behaviour of coronary arteries and other vasculature, direct controlled comparisons between different arteries are necessary for a better understanding of the differential response to restenosis. METHODS This study examines the response to stenting in coronary and internal iliac arteries as characterised by intimal hyperplasia and restenosis. In a swine model of in-stent stenosis, coronary arteries exhibited higher levels of intimal hyperplasia and per cent stenosis than internal iliac arteries. RESULTS After normalisation for injury score, coronary arteries were found to undergo 47% more intimal hyperplasia (p<0.05), whereas per cent stenosis normalised for injury score tended to be higher (p = 0.01). Other measurements reflecting post-stenting intimal hyperplasia (maximal intimal thickness, medial area) did not exhibit significant differences between the artery groups. CONCLUSIONS These results show that coronary vessels are more prone to develop significant intimal hyperplasia and subsequent restenosis than internal iliac vessels. A better insight into how different arteries and arterial components behave is important in understanding and developing newer and better therapeutic measures for restenosis.
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Affiliation(s)
- K D Krueger
- Department of Medical Microbiology, Creighton University School of Medicine, Omaha, Nebraska 68178, USA
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20
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Zhao C, Shuke N, Okizaki A, Yamamoto W, Sato J, Iwata K, Kanno T, Hasebe N, Kikuchi K, Aburano T. Naturally formed coronary arterial thrombus detected by In-111 oxine platelet imaging. Clin Nucl Med 2005; 30:492-5. [PMID: 15965327 DOI: 10.1097/01.rlu.0000167489.38148.1b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Chunlei Zhao
- Department of Radiology, Asahikawa Medical College Hospital, Asahikawa, 078-8510 Japan.
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21
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Pakala R, Rha SW, Kuchulakanti PK, Cheneau E, Baffour R, Waksman R. Peroxisome proliferator-activated receptor gamma; Its role in atherosclerosis and restenosis. ACTA ACUST UNITED AC 2005; 5:44-8. [PMID: 15275632 DOI: 10.1016/j.carrad.2004.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cellular proliferation and migration are fundamental processes that contribute to the injury response in major blood vessels. The resultant pathologies are atherosclerosis and restenosis. As we begin to understand the cellular changes associated with vascular injury, it is critical to determine whether the inhibition of growth and movement of cells in the vasculature could serve as a novel therapeutic strategy to prevent atherosclerosis and restenosis.
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Affiliation(s)
- Rajbabu Pakala
- Cardiovascular Research Institute, Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA
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22
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Abendschein DR, Yang LY, Chun J, Cho D, Scherrer D, St Pierre J. Prolonged procoagulant activity on overstretch-injured coronary arteries in pigs. J Thromb Haemost 2003; 1:836-42. [PMID: 12871423 DOI: 10.1046/j.1538-7836.2003.00100.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study was designed to assess the time course and nature of the vascular procoagulant response after 1.5-fold balloon overstretch injury of the coronary arteries in pigs. Arteries were excised for chromogenic assay of bound factor (F)Xa and thrombin at 24 h, 3 days, 1 week, or 2 weeks after injury. FXa at the site of injury remained elevated for 1 week (4.9 +/- 5.9 microg cm(-2), n = 10), compared with non-injured control arteries (0.4 +/- 0.2 microg cm(-2), n = 18, P = 0.00025), while thrombin was increased only at 24 h. Tissue factor protein was abundant in non-injured coronaries (10 +/- 6 ng microg(-1) total protein, n = 9) and levels were unchanged by injury (13 +/- 11 ng microg(-1), n = 6) or 24-h administration of tissue factor pathway inhibitor (16 +/- 6 ng microg(-1), n = 6). Persistent tissue factor-mediated procoagulant activity may explain the need for prolonged anticoagulation to attenuate neointimal formation after balloon-induced coronary injury.
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Affiliation(s)
- D R Abendschein
- Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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23
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Wang J, Felux D, VandeBerg J, Wang XL. Discordance of endothelial nitric oxide synthase in the arterial wall and its circulating products in baboons: interactions with redox metabolism. Eur J Clin Invest 2003; 33:288-95. [PMID: 12662158 DOI: 10.1046/j.1365-2362.2003.01143.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although peripheral arteries and circulating factors have been frequently used to assess systemic or central arterial, such as coronary artery, endothelial nitric oxide synthase (eNOS) functions, there is no direct evidence to support that they are related. DESIGN We explored relationships in eNOS levels among coronary, aortic, carotid and brachial arteries, and interactions with redox metabolisms in 40 necropsied baboons (Papio hamadryas). RESULTS We found no correlations in eNOS or NOx levels among all four arteries (R: 0.02-0.19, P > 0.05). While eNOS levels were high in both coronary (133.78 +/- 10.9 pg mg-1 protein) and aortic arteries (168.53 +/- 16.32 pg mg-1 protein), they were low in brachial (82.88 +/- 5.5 pg mg-1 protein) and carotid (89.83 +/- 7.15 pg mg-1 protein) arteries. Arterial eNOS were not correlated with plasma NOx either. However, coronary and aortic eNOS were positively correlated with the corresponding arterial total antioxidant status (TAS) (r = 0.638, P= 0.001, and r = 0.615, P= 0.0001). Coronary eNOS was also negatively associated with coronary advanced glycation end products (AGE) (r = -0.454, P= 0.003). Furthermore, there were significant associations in TAS levels between plasma and arterial wall extracts (R: 0.344-0.369, P < 0.05) and among arteries of different anatomic sites (R: 0.637-0.877, P < 0.001). While arterial TAS was negatively correlated with corresponding arterial AGE, TAS in the arterial wall and plasma were positively associated with plasma AGE. CONCLUSIONS Our study shows that eNOS is differentially expressed in different anatomic sites and is not associated with plasma NOx, suggesting that brachial eNOS may not be used to assess coronary eNOS. The positive or negative associations between eNOS and TAS or AGE, especially in the coronary artery, indicate an important role of eNOS in arterial wall redox balance.
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Affiliation(s)
- J Wang
- Department of Genetics, Southwest Foundation for Biomedical Research, San Antonio, TX, USA
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24
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Affiliation(s)
- Mohan N Babapulle
- Division of Cardiology, Montreal General Hospital/McGill University, Montreal, Quebec, Canada
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25
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Gabeler EEE, van Hillegersberg R, Statius van Eps RG, Sluiter W, Gussenhoven EJ, Mulder P, van Urk H. A comparison of balloon injury models of endovascular lesions in rat arteries. BMC Cardiovasc Disord 2002; 2:16. [PMID: 12350231 PMCID: PMC130046 DOI: 10.1186/1471-2261-2-16] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2002] [Accepted: 09/27/2002] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Balloon injury (BI) of the rat carotid artery (CCA) is widely used to study intimal hyperplasia (IH) and decrease in lumen diameter (LD), but CCA's small diameter impedes the evaluation of endovascular therapies. Therefore, we validated BI in the aorta (AA) and iliac artery (CIA) to compare it with CCA. METHODS Rats underwent BI or a sham procedure (control). Light microscopic evaluation was performed either directly or at 1, 2, 3, 4 and 16 weeks follow-up. The area of IH and the change in LD (LD at 16 weeks minus LD post BI) were compared. RESULTS In the BI-groups the area of IH increased to 0.14 +/- 0.08 mm2 (CCA), 0.14 +/- 0.03 mm2 (CIA) and 0.12 +/- 0.04 mm2 (AA) at 16 weeks (NS). The LD decreased with 0.49 +/- 0.07 mm (CCA), compared to 0.22 +/- 0.07 mm (CIA) and 0.07 +/- 0.10 mm (AA) at 16 weeks (p < 0.05). The constrictive vascular remodelling (CVR = wall circumference loss combined with a decrease in LD) was -0.17 +/- 0.05 mm in CIA but absent in CCA and AA. No IH, no decrease in LD and no CVR was seen in the control groups. CONCLUSIONS BI resulted in: (1.) a decrease in LD in CCA due to IH, (2.) a decrease in LD in CIA due to IH and CVR, (3.) no change in LD in AA, (4.) Comparable IH development in all arteries, (5.) CCA has no vasa vasorum compared to CIA and AA, (6.) The CIA model combines good access for 2 F endovascular catheters with a decrease in LD due to IH and CVR after BI.
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Affiliation(s)
| | | | | | - Wim Sluiter
- Dept. of Biochemistry, Erasmus MC, Rotterdam, The Netherlands
| | - Elma J Gussenhoven
- Dept. of Experimental echocardiology (ICIN), Erasmus MC, Rotterdam, The Netherlands
| | - Paul Mulder
- Dept. of Epidemiology and Biostatistics, the Netherlands Institute for Health Sciences
| | - Hero van Urk
- Dept. of Surgery, Erasmus MC, Rotterdam, The Netherlands
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26
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Palmerini T, Nedelman MA, Scudder LE, Nakada MT, Jordan RE, Smyth S, Gordon RE, Fallon JT, Coller BS. Effects of abciximab on the acute pathology of blood vessels after arterial stenting in nonhuman primates. J Am Coll Cardiol 2002; 40:360-6. [PMID: 12106945 DOI: 10.1016/s0735-1097(02)01951-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study was designed to assess the effect of abciximab on platelet and leukocyte deposition 60 min after stent insertion in nonhuman primates. BACKGROUND Although it is well established that abciximab improves both short- and long-term clinical outcomes after stent placement, there have been no studies assessing its effect on early platelet and leukocyte deposition. METHODS Cynomolgus monkeys were pretreated with aspirin and either saline or a 0.4 mg/kg bolus of abciximab, and then subjected to angioplasty and Palmaz-Schatz stent placement in the common iliac artery or abdominal aorta. After 60 min, animals were euthanized and the stented artery was evaluated by immunohistochemistry and morphometry. RESULTS Complete occlusion of the stented vessel with a thin fibrin(ogen) meshwork and trapped blood occurred in two saline-treated and two abciximab-treated animals. In the four remaining saline-treated animals, a layer of erythrocytes trapped in a network of fibrin(ogen) was noted close to the vessel wall, and this was covered by a layer of large, irregular platelet thrombi. Leukocytes formed a monolayer on top of the platelets and near stent struts. In the four remaining abciximab-treated animals, the mean erythrocyte area was 65% smaller (p = 0.070), the platelet aggregate area was 89% smaller (p = 0.049) and the luminal area was 59% larger (p = 0.004). A monolayer of leukocytes also formed on top of the platelets and near stent struts. CONCLUSIONS In control stented blood vessels in this study, platelet thrombi formed not at the vessel wall, but on top of an erythrocyte-rich layer, and platelets recruited leukocytes. Abciximab decreased the size of platelet thrombi, but did not prevent leukocyte recruitment.
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Affiliation(s)
- Tullio Palmerini
- Istituto di Cardiologia, Policlinico S. Orsola, University of Bologna, Bologna, Italy
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27
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Sensky PR, Samani NJ, Horsfield MA, Cherryman GR. Restoration of myocardial blood flow following percutaneous coronary balloon dilatation and stent implantation: assessment with qualitative and quantitative contrast-enhanced magnetic resonance imaging. Clin Radiol 2002; 57:593-9. [PMID: 12096857 DOI: 10.1053/crad.2002.0947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM To examine the serial use of magnetic resonance imaging (MRI) to evaluate regional myocardial perfusion changes following percutaneous coronary angioplasty and stent implantation (PTCA). MATERIALS AND METHODS Six patients with single vessel coronary artery disease (CAD) underwent contrast-enhanced first pass MRI immediately prior to (visit A) and within 7 days after (visit B) PTCA. Three sequential short axis slices were obtained after gadodiamide (Gd) bolus (0.025 mmol/kg(-1)) at rest and during adenosine. Each short axis was divided radially into eight regions of interest (ROIs). ROIs were anatomically assigned to a coronary artery territory (CAT). Stress and rest qualitative and quantitative (unidirectional extraction fraction constant (K(i)); index of myocardial perfusion reserve (MPRI) = stressK(i) / restK(i)) perfusion parameters were determined for ROI supplied by remote and stenosed/stented vessels for each visit. RESULTS In stented ROIs the number of ROIs demonstrating normal perfusion, as opposed to reversible perfusion deficits, increased. Qualitative perfusion assessment in remote CATs was unchanged. MPRI in stenotic CATs was lower than in remote CATs at visit A (P < 0.001). Following PTCA, MPRI increased in stented CATs (P < 0.001) but was unchanged in remote CATs. CONCLUSION Restoration of myocardial perfusion following PTCA can be delineated with qualitative and quantitative perfusion MRI. Although at present the investigation is technically complex and not perfectly sensitive or specific, MRI has the potential to be a valuable tool for patient follow-up and evaluation of revascularization strategy efficacy.
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Affiliation(s)
- P R Sensky
- Department of Cardiology, University of Leicester, Glenfield Hospital, Leicester, UK.
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28
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Corti R, Osende JI, Fayad ZA, Fallon JT, Fuster V, Mizsei G, Dickstein E, Drayer B, Badimon JJ. In vivo noninvasive detection and age definition of arterial thrombus by MRI. J Am Coll Cardiol 2002; 39:1366-73. [PMID: 11955857 DOI: 10.1016/s0735-1097(02)01754-0] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the potential of magnetic resonance (MR) to detect arterial thrombotic obstruction and define thrombus age. BACKGROUND; Arterial thrombi underlie the clinical consequences of atherosclerosis and are not reliably detected by current noninvasive diagnostic techniques. METHODS Carotid thrombi were induced in swine (n = 7) by arterial injury. Serial high-resolution in vivo MR images were obtained using black-blood T1-weighted (T1W) and T2-weighted (T2W) sequences in a clinical 1.5T MR system at 6 h, 1 day and at 1, 2, 3, 6 and 9 weeks. At each time point one animal was sacrificed and the occluded carotid artery processed for histopathology. Thrombus signal intensity (SI) was normalized to that of the adjacent muscle. Thrombus age was assessed based on MR appearance by two blinded independent observers. RESULTS Thrombus appearance and relative SI revealed characteristic temporal changes in multicontrast-weighted MR images, reflecting histologic changes in the composition. Acute thrombus appeared very bright on the T2W images, facilitating the detection. Signal intensity was 197 +/- 25% at 6 h, peaking at 1 week (246 +/- 51%), reaching a plateau by 6 weeks (120 +/- 15%). At six weeks, complete thrombus organization was confirmed histologically. The T1W images had similar pattern with lower SI than T2W. Age definition using visual appearance was highly accurate (Pearson's chi-square with 4 df ranging from 96 to 132 and Cohen's kappa at 0.81 to 0.94). Agreement between observers was substantial (Pearson chi-square with 4 df = 91.5, kappa = 0.79). CONCLUSIONS Magnetic resonance imaging is a promising tool to noninvasively detect arterial thrombosis. Measurement of SI and the characteristic visual appearance of the thrombus have the potential to define thrombus age.
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Affiliation(s)
- Roberto Corti
- Cardiovascular Biology Research Laboratory, Mount Sinai Medical Center, New York, New York, USA
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29
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Maeng M, Olesen PG, Emmertsen NC, Thorwest M, Nielsen TT, Kristensen BO, Falk E, Andersen HR. Time course of vascular remodeling, formation of neointima and formation of neoadventitia after angioplasty in a porcine model. Coron Artery Dis 2001; 12:285-93. [PMID: 11428537 DOI: 10.1097/00019501-200106000-00004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vascular remodeling is the major cause of restenosis after coronary balloon angioplasty but the pathophysiology of this process is not known. OBJECTIVE To examine the time courses of vascular remodeling, formation of neointima and adventitial changes after coronary angioplasty. DESIGN An experimental study on pigs using coronary angiography, intravascular ultrasound (IVUS), and histology. METHODS Deep vessel-wall injury was induced by conventional balloon angioplasty in the circumflex and right coronary arteries, and by retraction of a chain-encircled balloon in the left anterior descending artery. Angiography in all three arteries and IVUS measurements in circumflex and left anterior descending arteries were performed before and after angioplasty, and at follow-up on days 0, 1, 4, 7, 14, 28, and 56 (n = 5 in each group). Serial IVUS measurements were used to determine vascular remodeling. Formation of neointima and neoadventitia was measured by histomorphometry. RESULTS Angiographically evident loss of lumen and ultrasonographically detectable constrictive remodeling occurred between day 7 and day 28. IVUS measurements showed that late loss of lumen (days 28 and 56) was correlated to vascular remodeling but not to the increase in wall area (neointima plus media). Histomorphometry revealed that neointima was present from day 7 and that amount of neointima increased up to day 28. Area of adventitia increased during the first 4 days and remained unchanged thereafter. Adventitial neovascularization by vasa vasorum was observed from day 4 onward. CONCLUSIONS Formation of neoadventitia precedes late loss of lumen, constrictive remodeling, and formation of neointima. The time course of vascular remodeling coincides with growth of neointima rather than with changes in the adventitia.
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Affiliation(s)
- M Maeng
- Department of Cardiology, Skejby University Hospital and Institute of Experimental Clinical Research, Aarhus University, Denmark
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30
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Hsueh WA, Jackson S, Law RE. Control of vascular cell proliferation and migration by PPAR-gamma: a new approach to the macrovascular complications of diabetes. Diabetes Care 2001; 24:392-7. [PMID: 11213897 DOI: 10.2337/diacare.24.2.392] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Compared with nondiabetic subjects, type 2 diabetic individuals are at an increased risk for coronary artery disease and coronary restenosis after angioplasty or stenting. Increased proliferation and migration of vascular smooth muscle cells (VSMCs) contribute importantly to the formation of both atherosclerotic and restenotic lesions. Therefore, pharmaceutical interventions targeting proteins that regulate VSMC growth or movement are a promising new approach to treat diabetes-associated cardiovascular disease. Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) is a member of the nuclear receptor superfamily that, when activated by thiazolidinedione (TZD) insulin sensitizers, regulates a host of target genes. All of the major cells in the vasculature express PPAR-gamma, including endothelial cells, VSMCs, and monocytes/macrophages. PPAR-gamma is present in intimal macrophages and VSMCs in early human atheromas. In an animal model of vascular injury; PPAR-gamma levels are substantially elevated in the neointima that forms after mechanical injury of the endothelium. Recent experimental studies provide evidence that PPAR-gamma may function to protect the vasculature from injury. Cell culture studies have shown that TZD PPAR-gamma ligands inhibit both the proliferation and migration of VSMCs. These antiatherogenic activities of PPAR-gamma may also occur in vivo, because TZDs inhibit lesion formation in several animal models. PPAR-gamma ligands may also protect the vasculature indirectly by normalizing metabolic abnormalities of the diabetic milieu that increase cardiovascular risk. Activation of PPAR-gamma, newly defined in vascular cells, may be a useful approach to protect the vasculature in diabetes.
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Affiliation(s)
- W A Hsueh
- Department of Medicine, University of California School of Medicine, Los Angeles 90095-7073, USA
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31
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Roque M, Cordon-Cardo C, Fuster V, Reis ED, Drobnjak M, Badimon JJ. Modulation of apoptosis, proliferation, and p27 expression in a porcine coronary angioplasty model. Atherosclerosis 2000; 153:315-22. [PMID: 11164420 DOI: 10.1016/s0021-9150(00)00421-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Smooth muscle cell (SMC) proliferation is a prominent feature of intimal hyperplasia after percutaneous coronary interventions. p27 is a critical regulator of cell proliferation. Our aims were to analyze the time course of p27 expression, Ki67 proliferative index, and apoptosis after angioplasty in the porcine coronary artery. We also investigated the effects of rapamycin--an antiproliferative drug--on these events. The expression of p27 and Ki67, and apoptosis were determined in porcine coronary arteries harvested at timed intervals from 1 h to 28 days after angioplasty. A gradual increase in p27 expression was observed from 7 to 28 days. Ki67 expression peaked by 7-14 days after angioplasty. By 21-28 days, Ki67 expression decreased, while p27 reached maximal levels. An early apoptotic response was found by 6 h, followed by a gradual return to baseline. Rapamycin induced a reduction in Ki67 proliferative index (2 +/- 0.5%) and an increase in apoptosis (7 +/- 1%) versus untreated animals at the 28-day time point (5 +/- 1 and 1 +/- 0.5%, respectively; P < 0.05). In summary, coronary angioplasty induced a rapid apoptotic response, followed by a progressive increase in proliferation. Later on, as p27 expression increased in the vessel wall, cell proliferation decreased. Modulation of cell cycle progression may be a useful therapeutic approach in the treatment of intimal hyperplasia after angioplasty.
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Affiliation(s)
- M Roque
- Cardiovascular Biology Research Laboratory, The Zena and Michael A. Wiener Cardiovascular Institute, New York, NY 10029-6574, USA
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32
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Reis ED, Roqué M, Cordon-Cardo C, Drobnjak M, Fuster V, Badimon JJ. Apoptosis, proliferation, and p27 expression during vessel wall healing: time course study in a mouse model of transluminal femoral artery injury. J Vasc Surg 2000; 32:1022-9. [PMID: 11054235 DOI: 10.1067/mva.2000.109763] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The balance between cell death and proliferation in the vessel wall influences neointimal formation, remodeling, and eventual luminal narrowing after arterial injury. In this study, the time course of apoptosis, proliferation, and expression of p27-a critical regulator of cell-cycle progression-is characterized in a mouse model of transluminal arterial injury associated with substantial neointimal formation. METHODS C57BL/6 mice underwent bilateral femoral artery injury by passage of an angioplasty guidewire. Expression of p27, Ki67 proliferative index, and apoptosis, as well as histomorphometry, were analyzed in cross sections of uninjured arteries and arteries harvested at different time intervals after injury. RESULTS In the uninjured arteries, no apoptotic cells were detected, and p27 and Ki67 were expressed in less than 5% of medial cells. After injury, apoptosis increased markedly in medial smooth muscle cells from 1 to 24 hours and decreased gradually thereafter. Ki67 proliferative index increased after 1 week, peaked at 2 weeks in both the media and neointima, and decreased thereafter. p27 expression was undetectable from 1 to 48 hours, and increased gradually from 1 to 4 weeks. Well-developed neointima was present at 2 and 4 weeks. CONCLUSIONS In vivo injury to the mouse femoral artery evokes a rapid apoptotic response and downregulation of p27, followed by gradual increase in proliferation. During later phases of arterial repair, p27 expression increases while a shift of proliferation rates toward baseline occurs. Future experiments using this model in genetically modified mice may help identify specific cell-cycle regulatory molecules as therapeutic targets for control of pathologic arterial healing.
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Affiliation(s)
- E D Reis
- Department of Surgery and The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY 10029-6574, USA
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Worthley SG, Helft G, Fuster V, Fayad ZA, Fallon JT, Osende JI, Roqué M, Shinnar M, Zaman AG, Rodriguez OJ, Verhallen P, Badimon JJ. High resolution ex vivo magnetic resonance imaging of in situ coronary and aortic atherosclerotic plaque in a porcine model. Atherosclerosis 2000; 150:321-9. [PMID: 10856524 DOI: 10.1016/s0021-9150(99)00386-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Atherosclerotic plaque composition is central to the pathogenesis of plaque disruption and acute thrombosis. Thus, there is a need for accurate imaging and characterization of atherosclerotic lesions. Even though there is no ideal animal model of atherosclerosis, the porcine model is considered to most closely resemble human atherosclerosis. We report the feasibility of MR imaging and characterizing of atherosclerotic lesions from in situ coronary arteries and aortas in an ex vivo setting and validate this with histopathology. Coronary and aortic atherosclerosis was induced in Yucatan mini-swine (n=4) by a combination of atherogenic diet (6 months) and balloon injury. All coronary arteries were imaged ex vivo on the intact heart, preserving the curvature of their course. The aorta also underwent MR imaging. The MR images were correlated with the matched histopathology sections for both the coronary arteries (n=54) and the aortas (n=43). MR imaging accurately characterized complex atherosclerotic lesions, including calcified, lipid rich, fibrocellular and hemorrhagic regions. Mean wall thickness for the coronary arteries (r=0.94, slope: 0.81) and aortas (r=0.94, slope: 0.81) as well as aortic plaque area (r=0.97, slope: 0.90) was accurately determined by MR imaging (P<0.0001). Coronary artery MR imaging is not limited by the curvature of the coronary arteries in the heart. MR imaging accurately quantifies and characterizes coronary and aortic atherosclerotic lesions, including the vessel wall, in this experimental porcine model of complex atherosclerosis. This model may be useful for future study of MR imaging of atherosclerosis in vivo.
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Affiliation(s)
- S G Worthley
- Cardiovascular Biology Research Laboratory, Zena and Michael A. Wiener Cardiovascular Institute, One Gustave L. Levy Place, P.O. Box 1030, 10029-6574, New York, NY, USA
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