Effect of balloon angioplasty and stenting following clips vs suture arterial stenosis: an experimental study

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.