Rs. Schwartz et al., DIFFERENTIAL NEOINTIMAL RESPONSE TO CORONARY-ARTERY INJURY IN PIGS AND DOGS - IMPLICATIONS FOR RESTENOSIS MODELS, Arteriosclerosis and thrombosis, 14(3), 1994, pp. 395-400
Neointimal hyperplasia occurs in the coronary arteries after percutane
ous revascularization procedures and is a reparative response that fre
quently causes recurrent stenosis. Prior animal studies have shown tha
t neointimal tissue thickness is proportional to the depth of arterial
injury. Because animal models are increasingly used to test therapeut
ic strategies against restenosis, the purpose of this study was to eva
luate the degree of neointimal thickening formed in the coronary arter
ies of pigs compared with dogs in response to severe injury. Fourteen
coronary arteries in six mongrel dogs and 18 coronary arteries in nine
pigs underwent severe arterial injury using tantalum metal coils deli
vered on oversized angioplasty balloons. Animals were killed after 4 w
eeks, and all coronary arteries were pressure perfusion fixed. Mean hi
stological injury scores and neointimal thicknesses for dogs were 1.9/-0.3 and 0.30+/-0.11, respectively, compared with 2.1+/-0.7 and 0.71/-0.36 for pigs. Thus, there was significantly less neointimal thicken
ing in dogs compared with pigs (P<.001) despite no differences in inju
ry (P=NS). The neointimal thickening differences translated into signi
ficantly different percent area stenoses: 55+/-24% for pigs versus 27/-13% for dogs (P<.001). Linear regression modeled neointimal thicknes
s versus injury assessed by an ordinal injury score proportional to th
e depth of injury for each species. This analysis confirmed the differ
ences across multiple injury levels. The slope of the regression line
for dogs was small, suggesting that no relation may exist between inju
ry and neointimal thickness in this species. The pig may be a more app
ropriate model for the study of the genesis of stenosing neointima. If
the lack of response in dogs could be better understood, insight into
more effective restenosis therapies might be possible.