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Cai W, Chen E, Zheng H, Hu D, Wu L, Zeng X, Huang J, Chen L. Mid-Term Outcomes of Novel Covered Stent with Biodegradable Membrane in Porcine Coronary Artery Perforation. Rev Cardiovasc Med 2023; 24:197. [PMID: 39077012 PMCID: PMC11266466 DOI: 10.31083/j.rcm2407197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/27/2023] [Accepted: 02/28/2023] [Indexed: 07/31/2024] Open
Abstract
Background Currently, commercially covered stents are the main treatment for coronary artery perforation (CAP), but without satisfied late-term outcomes when compared to drug-eluting stents (DES). This study seeks to report a new covered stent to treat porcine CAP, which is manufactured with DES and a biodegradable membrane fabricated by poly-L-lactic acid (PLLA) polymer. Methods Experimental swines experienced CAP in proximal-middle of right coronary artery (RCA) by non-compliant balloon burst, and covered stent was deployed in breach segment. Meanwhile, coronary angiography (CAG), optical coherence tomography (OCT), histological light microscopy and scan electron microscopy were performed to characterize the performance of covered stent. Results Seven swines were used for this study. Two swines were euthanasia at 14 days and 28 days after procedure, respectively. The remaining 5 kept alive until sacrifice at six months. CAG at six months showed total occlusion at the stented segment of RCA in all swines. The interventional revascularization of occlusion lesion was instituted in two swines. After recanalizing occlusion lesion, OCT examination visualized diffuse heterogeneous fibrous plaques, as well as organized thrombosis, lipid deposits and several neoatherosclerosis in the occluded segment. Serial histopathologic and electron microscopies at 14 days, 28 days and six months revealed gradual occlusive vessel lumen with diffuse heterogeneous fibroplasia, smooth muscle proliferation, inflammation response and local neoatherosclerosis, moreover with identification of PLLA polymer membrane degradability. Conclusions The new covered stent with biodegradable membrane could seal urgent coronary breach and prevent experimental swines death, but with all stent occlusion in mid-term (six months) follow-up, which might be attributed to diffuse heterogeneous fibroplasia, smooth muscle proliferation, inflammation response and local neoatherosclerosis with the degradation of PLLA membrane.
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Affiliation(s)
- Wei Cai
- Department of Cardiology, Fujian Heart Medical Center, Fujian Institute of
Coronary Artery Disease, Fujian Institute of Geriatrics, Fujian Medical
University Union Hospital, 350001 Fuzhou, Fujian, China
| | - En Chen
- Department of Cardiology, Fujian Heart Medical Center, Fujian Institute of
Coronary Artery Disease, Fujian Institute of Geriatrics, Fujian Medical
University Union Hospital, 350001 Fuzhou, Fujian, China
| | - Hong Zheng
- Department of Cardiology, Fujian Heart Medical Center, Fujian Institute of
Coronary Artery Disease, Fujian Institute of Geriatrics, Fujian Medical
University Union Hospital, 350001 Fuzhou, Fujian, China
| | - Danqing Hu
- School of Health, Fujian Medical University, 350005 Fuzhou, Fujian, China
| | - Lingzhen Wu
- Department of Cardiology, Fujian Heart Medical Center, Fujian Institute of
Coronary Artery Disease, Fujian Institute of Geriatrics, Fujian Medical
University Union Hospital, 350001 Fuzhou, Fujian, China
| | - Xiaoling Zeng
- Department of Cardiology, Fujian Heart Medical Center, Fujian Institute of
Coronary Artery Disease, Fujian Institute of Geriatrics, Fujian Medical
University Union Hospital, 350001 Fuzhou, Fujian, China
| | - Jinhua Huang
- Department of Cardiology, Fujian Heart Medical Center, Fujian Institute of
Coronary Artery Disease, Fujian Institute of Geriatrics, Fujian Medical
University Union Hospital, 350001 Fuzhou, Fujian, China
| | - Lianglong Chen
- Department of Cardiology, Fujian Heart Medical Center, Fujian Institute of
Coronary Artery Disease, Fujian Institute of Geriatrics, Fujian Medical
University Union Hospital, 350001 Fuzhou, Fujian, China
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