雷帕霉素洗脱支架置入动物体内后的支架内皮化进程

The process of endothelialization after implantation of Cypher^(TM) stent in animal

目的研究雷帕霉素洗脱支架(CypherTM)对血管内皮再生的影响。方法杂种犬6只,经麻醉后行血管造影,选择动脉血管直径为2.25 mm的直血管段在远端及近端分别置入直径为2.25 mm的CypherTM支架及Bx son ic支架。术后仍继续给予抗血小板治疗,分别在术后1月、3月时行再次血管造影后取标本行扫描电镜检查。结果术后1月、3月血管造影CypherTM支架及Bx son ic支架均无管腔丢失。1月时扫描电镜显示CypherTM支架内皮覆盖不完整,有一定的血小板黏附、聚集;Bx son ic支架内皮覆盖完整,未见血小板黏附聚集。3月时CypherTM支架及Bx son ic支架内皮覆盖均较完整,无血小板黏附、聚集。结论CypherTM支架内皮再生较裸金属支架缓慢,有一定的血小板激活。3个月时才能完全实现内皮化。置入CypherTM支架的患者应进行更为严格的抗血小板治疗。

Objective To evaluate the effects of Cypher^TM Stent on endothelium regeneration and platelet activation after angioplasty. Methods Six mongrel dogs were implanted Cypher^TM stent and Bx sonic stent in the same artery. The target vessels were ablated after angiography and observed by scanning electron microscope at one month and three months after implantation of stents respectively. Result At one month, target vessels of Cypher^TM stent were covered with endothelium partly and platelet activation was observed. Target vessels of Bx sonic stent were entirely covered with endothelium and platelet activation wasnt observed. Three months later, target vessels of Cypher^TM stent and Bx sonic stent were entirely covered with endothelium and there was no platelet activation on the vessel surface for both groups. Conclusion Endothelium regeneration after implantation of Cypher^TM stent was much slower than that of implantation of bare metallic stent, and at three months, the endothelialization was finished. Intensive anti-platelet therapy should be considered after implantation of Cypher^TM stent.