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Biological response to expandable metallic stents implanted into the portal vein. A histomorphometric study
K Miyazaki1, T Nishibe, S Watanabe
1Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Background:
This study was undertaken to investigate the biological response to an expandable metallic stent implanted in the canine portal vein with a special reference to the histomorphometric contribution of cellular and acellular elements to the intimal and medial growth.
Methods:
In 11 dogs, the Gianturco Z stent was placed into the portal vein and was harvested at intervals of 4 (n=6) and 12 weeks (n=5). In 6 dogs, the normal portal vein was harvested and used as a control. The specimens were subjected to histomorphometric examination.
Results:
Mean intimal/medial thickness and total intimal/medial area significantly increased progressively by 12 weeks. Collagen intimal/medial area also significantly increased progressively by 12 weeks, while smooth muscle intimal/medial area significantly increased at 4 weeks but did not change from 4 weeks to 12 weeks. Collagen density tended to increase at 4 weeks and significantly increased at 12 weeks, while smooth muscle density significantly decreased at 4 weeks and continued to decrease at 12 weeks.
Conclusions:
The total area or mean thickness of the intima and media of the stented portal vein continued to increase by 12 weeks after stent placement. This phenomenon appeared to be due to proliferation of smooth muscle cells followed by accumulation of collagen.