Pb. Dimakakos et al., Effect of balloon angioplasty and stenting following clips vs suture arterial stenosis: an experimental study, VASA, 29(1), 2000, pp. 35-39
Background: Comparative evaluation of balloon angioplasty following intrava
scular stenting after experimental stenoses caused by arterial reconstructi
on with vascular clips and conventional sutures.
Materials and methods: A total of 24 arteriotomies were carried out at the
carotid and common iliac arteries of pigs following a 10mm longitudinal art
eriotomy and provocation of stenosis. Twelve of the arteries were reconstru
cted with vascular clips and 12 with conventional suture. Ultrasonography r
evealed stenosis fluctuating from 60-95% (PSV: 1.8-3.5 m/sec EDV: 1.3-1.47
m/sec PSV ratio > 3.5). After 8 weeks, following digital subtraction angiog
raphy which revealed >50% stenosis in all of the cases, balloon angioplasty
followed by placement of intravascular stent was carried out.
Results: All the angioplasties remained angiographically and macroscopicall
y patent two months after without thrombus formation. Rupture during dilata
tion occurred in one of the sutured cases. Histologically no degenerative c
hanges, necrosis or remarkable intimal thickness were observed in either me
thod. Focal inflammatory reaction was seen in 2 sutured and in 1 clipped ca
ses while intimal ulceration was observed in 2 sutured cases. All cases wit
h clips presented an intact endothelial surface.
Conclusion: Early experimental results suggested that arterial stenosis pro
voked by clipped reconstruction could be managed successfully by balloon an
gioplasty followed by placement of intravascular stent.