Study of the Patency of Small Arterial Branches after Stent Placement with an Experimental in Vivo Model
Osamu Masuoa,
Tomoaki Teradaa,
Gary Walkerb,
Mitsuharu Tsuuraa,
Hiroyuki Matsumotoa,
Kazuo Tohyac,
Michio Kimurac,
Kunio Nakaia and
Toru Itakuraa
a Department of Neurological Surgery, Kansai College of Oriental Medicine, Osaka, Japan
b Wakayama Medical College, the Guidant Corporation, CA, Kansai College of Oriental Medicine, Osaka, Japan
c Department of Anatomy, Kansai College of Oriental Medicine, Osaka, Japan
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FIG 1. Representative case (case 4).
A, Diameter of abdominal aorta is measured by using a measure wire.
B, Angiography is performed before stenting.
C, Just after stenting, angiography is performed to evaluate the patency of the lumbar artery (arrow).
D, Follow-up angiogram, obtained 3 months after stenting, confirms that the lumbar artery remains patent (arrow).
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FIG 2. Case 5. Scanning electron microscopic findings obtained 1 week after stenting for the rabbit that became paraparetic after stenting reveal that the lumbar artery (asterisk) in the stent is patent without thrombus. The diameter of the lumbar artery is 729 µm. Endothelial integrity is injured along the struts by stent expansion (arrows), and underlying smooth muscle fiber is exposed in part of the luminal surface because of post-processing (original magnification x100).
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FIG 3. Representative case (case 4). Scanning electron microscopic findings obtained 3 months after stent placement reveal an open ostium of the lumbar artery (asterisk) and also show that regenerated endothelial-like cells are covered with stent strut in contact with the aorta and extend to the struts crossing the ostium of the lumbar artery (arrows). In this case, the extension of the regenerated endothelial cells into the ostia of lumbar arteries was observed (arrow), although the degree of narrowing due to this extension was not significant.
A, Original magnification x80.
B, Original magnification x150.
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FIG 4. Microscopic findings stained with hematoxylin and eosin reveal that the luminal surface of the struts (S) across the ostium of the lumbar artery (asterisk) is lined with a monolayer of cells resembling regenerative endothelial cells.
A, Original magnification x200.
B, Original magnification x400.
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