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Tissue response to covered Wallstents
B L Dolmatch1, Y H Dong, S O Trerotola
1Department of Radiology, Cleveland Clinic Foundation, OH 44195, USA.
Summary
Polyethylene terephthalate interbraided Wallstents (PET-WSs) induced inflammation, unlike bare mesh Wallstents (WSs) or ePTFE-covered WSs. All stent-graft types showed excellent patency in this canine iliac artery model.
Area of Science:
- Vascular surgery
- Biomaterials science
- Histopathology
Background:
- Endoluminal stent-grafts are crucial in treating vascular diseases.
- Understanding the biocompatibility and healing response of different stent-graft materials is essential for clinical success.
Purpose of the Study:
- To compare the healing responses of bare mesh Wallstents (WSs), polyethylene terephthalate interbraided WSs (PET-WSs), and ePTFE-covered WSs in a canine iliac artery model.
Main Methods:
- Three types of Wallstents (bare WS, PET-WS, ePTFE-WS) were implanted in 12 dogs' iliac arteries.
- Arteriograms were taken pre-implantation, post-implantation, and at explantation.
- Devices were explanted at 1, 3, and 6 months for histological analysis.
Main Results:
- All implant types demonstrated excellent patency, with only one ePTFE-WS thrombosing.
- Bare WS and ePTFE-WS showed uniform myointimal healing without inflammation.
- PET-WS exhibited significant foreign body inflammation and a thicker neointimal response.
Conclusions:
- Polyethylene terephthalate stent-grafts induced chronic inflammation, potentially explaining adverse events in human studies.
- Bare mesh and ePTFE-covered Wallstents demonstrated favorable healing responses.
- Excellent patency was observed across all tested stent-graft types in this model.