光学相干断层成像技术评价猪冠状动脉佐他莫司洗脱支架术后早期新生内膜覆盖情况

摘要

目的:应用光学相干断层成像(OCT)、病理和扫描电镜评价猪冠状动脉佐他莫司洗脱支架(ZES)术后早期(7天、14天、28天)新生内膜覆盖情况.方法:18只中华小型猪随机分为7天组、14天组和28天组,每组6只,每只猪于右冠状动脉置入一枚佐他莫司洗脱支架,3组实验动物分别于术后7天、14天及28天时进行OCT检查,观察支架表面新生内膜覆盖情况,并取支架段冠状动脉进行病理组织学检查及扫描电镜观察.结果:用OCT观察3个时间段支架表面新生内膜情况,7天组为(61.3±37.7) μm,14天组为(132.6±103.3)μm,28天组为(244.3±282.3)μm,3组间差异有统计学意义(P＜0.001),新生内膜覆盖率7天组为(53.62±2.49)％,28天组达到(94.88±2.93)％,病理提示7天时新生内膜以炎性细胞、红细胞、血小板为主,28天时以平滑肌细胞、炎性细胞和血管内皮细胞为主.结论:OCT在支架术后7天即能清晰观察到新生内膜覆盖情况,佐他奠司洗脱支架术后28天大多数支架丝被新生内膜覆盖.%Objective: To evaluate the neointimal coverage at the early stage after zotarolimus-eluting stents (ZES) implantation in porcine coronary artery by optical coherence tomography (OCT) and scanning electron microscope image.rnMethods;There were 18 mini-pigs used in our study,each one received a ZES implantation in its right coronary artery. Then the animals were examined at different time points as 3 groups of 7 days, 14 days, and 28 days after the implantation, n = 6 in each group. The neointimal coverage in stent surface was examined by OCT,the histological changes in related coronary segments were observed by scanning electron microscope.rnResults:OCT examination showed that there were significant differences of neointimal thickness in stent surface among 3 groups as at 7 days (61. 3±37. 7)μm, 14 days (132.6±103.3)μm and 28 days (244. 3±282. 3)μm,P<0. 001 respectively. The rate of neointimal coverage also presented obvious differences among 3 groups, at 7 days (53. 62 ± 2.49 ) % , and at 28 days it reached (94. 88 ± 2. 93)%. The scanning electron microscope image indicated that 7 days after implantation,the neointima were mainly having inflammatory cells,red blood cells and platelets,while 28 days after implantation,the smooth muscle cells,inflammatory cells and endothelial cells were more observed.rnConclusion: Neointima could be clearly seen by OCT at 7 days after stent implantation and most of the struts were covered with neointima at 28 days after ZES implantation.