Patency of Perforating Arteries after Stent Placement? A Study Using an In Vivo Experimental Atherosclerosis-Induced Model
Osamu Masuoa,
Tomoaki Teradaa,
Gary Walkerb,
Mitsuharu Tsuuraa,
Kunio Nakaia and
Toru Itakuraa
a Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan
b Guidant Corporation, CA
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FIG 1. Angiographic change in a representative case (case 1).
A–D, Angiograms obtained after denudation (A), 6 weeks after denudation but before stent placement (B), immediately after stent placement (C), and at follow-up 3 months after stent placement (D). Arrow in B indicates stenotic lesion before stent placement.
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FIG 2. Angiographic change and SEM findings in a representative case (case 2).
A, Prestenting angiogram shows stenotic change at the level of the lumbar artery orifice (arrow).
B, Angiogram obtained after stent placement shows that the stenotic lesion is improved and the lumbar artery is patent.
C, SEM image (original magnification, X40) shows that the stent struts crossing the orifice of the lumbar artery are covered with thick neointima, and the lumbar artery orifice becomes narrow.
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FIG 3. Representative SEM findings (case 3). SEM image (original magnification, X40) shows that the ostium of the lumbar artery has luminal narrowing due to a thick neointima.
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FIG 4. Case of intraluminal thrombus (case 6).
A, Follow-up angiogram demonstrates intraluminal thrombus at the L4 level and occlusion of the L4 lumbar artery. Arrow indicates intraluminal thrombus.
B and C, Microscopic analysis shows intraluminal thrombus surrounding the stent struts that cross the ostium. (B, hematoxylin-eosin staining, original magnification, X12.5. C, hematoxylin-eosin staining, original magnification, X40.)
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AJNR - American Journal of Neuroradiology