Skip to main content
SpringerLink
Log in

Neointimal hyperplasia in low-profile nitinol stents, palmaz stents, and wallstents: A comparative experimental study

  • Laboratory Investigations
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

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 andp<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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cragg AH, DeJong SC, Barnhart WH, Landas SK, Smith TP (1993) Nitinol intravascular stent: Results of preclinical evaluation. Radiology 189:775–778

    PubMed  CAS  Google Scholar 

  2. Hausegger KA, Cragg AH, Lammer J, Lafer M, Flückiger F, Klein GE, Sternthal MH, Pilger E (1994) Iliac artery stent placement: Clinical experience with a Nitinol stent. Radiology 190:199–202

    PubMed  CAS  Google Scholar 

  3. Vorwerk D, Günther RW, Schürmann K, Wendt G, Peters I (1995) Primary stent placement for chronic iliac artery occlusion: Follow-up in 103 patients. Radiology 194:745–749

    PubMed  CAS  Google Scholar 

  4. Palmaz JC, Laborde JC, Rivera FJ, Ecarnacion E, Lutz JD, Moss JG (1992) Stenting of the iliac arteries with the Palmaz stent: Experience from a multicenter trial. Cardiovasc Intervent Radiol 15:291–297

    PubMed  CAS  Google Scholar 

  5. Zollikofer CL, Antonucci F, Stuckmann G, Mattias P, Brühlmann WF, Salomonowitz EK (1992) Use of the Wallstent in the venous system including hemodialysis-related stenoses. Cardiovasc Intervent Radiol 15:334–341

    PubMed  CAS  Google Scholar 

  6. Palmaz JC, Garcia OJ, Schatz RA, Rees CR, Roeren T, Richter GM, Noeldge G, Gardiner GA, Becker GJ, Walker C, Stagg J, Katzen BT, Dake MD, Paolini RM, McLean GK, Lammer J, Schwarten DE, Tio FO, Root HD, Rogers W (1990) Placement of balloon-expandable intraluminal stents in iliac arteries: First 171 procedures. Radiology 174:969–975

    PubMed  CAS  Google Scholar 

  7. Joffre F, Rousseau H, Bernadet P, Nomblot C, Montoy JC, Chemali R, Knight C (1992) Midterm results of renal artery stenting. Cardiovasc Intervent Radiol 15:313–318

    PubMed  CAS  Google Scholar 

  8. Zollikofer CL, Antonucci F, Stuckmann G, Mattias P, Salomonowitz EK (1992) Historical overview on the development and characteristic of stents and future outlook. Cardiovasc Intervent Radiol 15:272–278

    PubMed  CAS  Google Scholar 

  9. Palmaz JC (1992) Intravascular stents: From basic research to clinical application. Cardiovasc Intervent Radiol 15:279–284

    PubMed  CAS  Google Scholar 

  10. Stemermann MB, Spaet TH, Pitlick F, Cintron J, Lejnieks I, Tiell L (1987) Intimal healing. Am J Pathol 87:125–142

    Google Scholar 

  11. Palmaz JC (1993) Intravascular stents: Tissue-stent interactions and design considerations. AJR 160:613–618

    PubMed  CAS  Google Scholar 

  12. DePalma VA, Baier RE, Ford JW, Glott VL, Furuse A (1972) Investigation of three-surface properties of several metals and their relation to blood compatibility. J Biomed Mater Res 6:37–75

    Article  PubMed  CAS  Google Scholar 

  13. Baier RE, Dutton RC (1969) Initial events in interaction of blood with a foreign surface. J Biomed Mater Res 3:191–206

    Article  PubMed  CAS  Google Scholar 

  14. Nöldge G, Richter GM, Siegerstetter V, Garcia O, Palmaz JC (1990) Tierexperimentelle Untersuchungen über den Einfluß der Flußrestriktion auf die Thrombogenität des Palmaz Stentes mittels111Indium-markierter Thrombozyten. Fortschr Röntgenstr 152 (3):264–270

    Google Scholar 

  15. Dichek DA, Neville RF, Zwiebel JA, Freeman SM, Leon MB, Anderson WF (1989) Seeding of intravascular stents with genetically engineered endothelial cells. Circulation 80:1347–1353

    PubMed  CAS  Google Scholar 

  16. Ross R, Glomset J, Kariya B, Harker L (1974) A platelet-dependent serum factor that stimulates the proliferation of arterial smooth muscle cells in vitro. Proc Natl Acad Sci USA 71:1207–1210

    Article  PubMed  CAS  Google Scholar 

  17. Schatz RA (1989) A view of vascular stents. Circulation 79:445–457

    PubMed  CAS  Google Scholar 

  18. Palmaz JC, Garcia O, Kopp DT, Schatz RA, Tio FO (1987) Balloon-expandable intraarterial stens: Effect of anticoagulation on thrombus formation. (abstract) Circulation 76 [Suppl 4]:45

    Google Scholar 

  19. Tominaga R, Kambic H, Emoto H, Harasaki H, Sutton C, Hollmann J (1992) Effects of design geometry of itnravascular endoprostheses on stenosis rate in normal rabbits. Am Heart J 123:21–28

    Article  PubMed  CAS  Google Scholar 

  20. Barth K, Virmani R, Froelich J, Lossef S, Takeda T, Lidisch D, Newsome J (1994) Neointima formation to Palmaz stents, Wallstents and Strecker Tantalum stents in comparative experimental studies. (abstract). Cardiovasc Intervent Radiol 17 [Suppl 2]: 58

    Google Scholar 

  21. Flueckinger F, Sternthal H, Klein GE, Aschauer M, Szolar D, Kleinhappl G (1994) Strength, elasticity, and plasticity of expandable metal stents: In vitro studies with three types of stress. J Vasc Intervent Radiol 5:745–750

    Article  Google Scholar 

  22. Vorwerk D, Redha F, Neuerburg J, Clerc C, Günther RW (1994) Neointima formation following arterial placement of self-expanding stents of different radial force: Experimental results. Cardiovasc Intervent Radiol 17:27–32

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, University of Technology, Pauwelsstraße 30, D-52057, Aachen, Germany

    Karl Schürmann M.D., Dierk Vorwerk, Arthur Kulisch, Eva Stroehmer-Kulisch & Rolf W. Günther

  2. Department of Pathology, University of Technology, Pauwelsstraße 30, D-52057, Aachen, Germany

    Stefan Biesterfeld

  3. Department of Experimental Animal Research, University of Technology, Pauwelsstraße 30, D-52057, Aachen, Germany

    Tadeusz Stopinski

Authors
  1. Karl Schürmann M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dierk Vorwerk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arthur Kulisch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eva Stroehmer-Kulisch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stefan Biesterfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tadeusz Stopinski
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rolf W. Günther
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schürmann, K., Vorwerk, D., Kulisch, A. et al. Neointimal hyperplasia in low-profile nitinol stents, palmaz stents, and wallstents: A comparative experimental study. Cardiovasc Intervent Radiol 19, 248–254 (1996). https://doi.org/10.1007/BF02577644

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02577644

Key words

Search

Navigation