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Neointimal hyperplasia in low-profile Nitinol stents, Palmaz stents, and Wallstents: a comparative experimental study
K Schürmann1, D Vorwerk, A Kulisch
1Department of Diagnostic Radiology, University of Technology, Pauwelsstrasse 30, D-52057 Aachen, Germany.
Purpose:
To compare neointima formation following insertion of low-profile Nitinol stents, Palmaz stents, and Wallstents.
Methods:
Nitinol stents, Palmaz stents, and Wallstents similar in size were transfemorally inserted into the iliac arteries of 12 sheep. Four stents per sheep were deployed; the position of the stents was varied so that each type of stent was placed in each position (right or left, proximal or distal) with equal frequency. Stent patency was followed by angiography. Six sheep were euthanized after 1 month, and the remaining six after 6 months. Iliac arteries were removed en bloc and prepared for histological examination. Neointimal and medial thickness were measured by light microscopy, and measurements were analyzed statistically.
Results:
Mean neointimal thickness both over (NO) and between (NB) the stent struts was greater in Wallstents (NO = 0.341 mm, NB = 0.368 mm) than in the Nitinol (NO = 0.260 mm, NB = 0.220 mm) and Palmaz stents (NO = 0.199 mm, NB = 0. 204 mm), but differences were not significant (p > 0.05). Medial atrophy in the area between the stent struts was greater in Wallstents compared with Nitinol and Palmaz stents (p < 0.007 and p < 0.02, respectively); in the area under the stent struts there was a significant difference only between Palmaz stents and Wallstents (p < 0.02).
Conclusion:
Under defined experimental conditions, none of the three types of stent appears to be preferable to the others regarding neointima formation in the short- to mid-term follow-up period.