Porcine model of stent thrombosis: Platelets are the primary component of acute stent closure

Myung Ho Jeong, Whyte G. Owen, Michael E. Staab, Sanjay S. Srivatsa, Giuseppe Sangiorgi, Marylou Stewart, David Holmes, Robert S. Schwartz

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Acute stent thrombosis remains a major concern of coronary stent implantation. Animal studies using stents do not adequately mimic this clinical problem, since stent placement is rarely associated with acute closure. The purpose of this study was to develop end characterize a porcine model of stent thrombosis. Improved understanding through such a model may be useful toward preventing and treating acute stent closure. Whole blood was drawn from domestic crossbred swine one day before study. Platelets were isolated, labeled with 111-In tropolone, and reinjected within 18 hr of the study. Bilateral carotid arteries were exposed, and severes injury induced by a series of mechanical crushes. This method produced histologic injury similar to human coronary angioplasty, with medial disruption and large dissections protruding into the lumen. Stenting was performed in standard fashion with 3.5-mm JJIS stents. Local platelet deposition was measured and recorded as 111-In radioactivity using a miniaturized scintillation detector (Dosimeter Corp.) mounted directly at the artery Injury site. This measurement was made in real time at 1-min intervals. Similarly, volumetric blood flow was measured in real time by Doppler flowmeter. Eighteen arteries of nine pigs were studied. In nine arteries from nine pigs, crush Injury only was performed and monitored. In the contralateral artery, crush injury was followed immediately by placement of a 3.5-mm Palmaz-Schatz (coronary) stent. Blood flow decreased rapidly following injury in both groups and followed a cyclic pattern. Eight arteries of the crush alone and two arteries of the crush plus stent groups were totally occluded 1 hr after crush. 111-In counts normalized to baseline were significantly higher at 1 hr in both groups compared to baseline; in the stented group, counts were higher than in the unstented group. Blood flow was higher In the sleeted group than in unstented group for 1 hr. Histopathologic observation of the thrombi forming in both crush-only and crushstent injuries showed severe medial dissections with obstructing medial flap formation. The thrombi forming in both groups were highly platelet rich. This model of stent and arterial thrombosis showed rapid formation of platelet-rich thrombus, cyclic blood flow variations, and acute occlusion in 20% of cases. Stent placement at arterial injury sites is associated with thrombus that Is predominantly platelet rich. Stent placement at injury sites enhances platelet deposition over crush Injury alone. Despite greater numbers of platelets, as shown by increased 111-In counts, stenting improved vessel patency. These were likely due to higher volumetric blood flow, continuous deposition, and embolization of labeled platelets.

Original languageEnglish (US)
Pages (from-to)38-43
Number of pages6
JournalCatheterization and cardiovascular diagnosis
Volume38
Issue number1
DOIs
StatePublished - May 1 1996

Fingerprint

Stents
Thrombosis
Swine
Blood Platelets
Arteries
Wounds and Injuries
Dissection
Tropolone
Flowmeters
Platelet Count
Angioplasty
Carotid Arteries
Radioactivity
Observation

Keywords

  • 111-In
  • acute stent closure
  • platelets
  • porcine model

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Porcine model of stent thrombosis : Platelets are the primary component of acute stent closure. / Jeong, Myung Ho; Owen, Whyte G.; Staab, Michael E.; Srivatsa, Sanjay S.; Sangiorgi, Giuseppe; Stewart, Marylou; Holmes, David; Schwartz, Robert S.

In: Catheterization and cardiovascular diagnosis, Vol. 38, No. 1, 01.05.1996, p. 38-43.

Research output: Contribution to journalArticle

Jeong, Myung Ho ; Owen, Whyte G. ; Staab, Michael E. ; Srivatsa, Sanjay S. ; Sangiorgi, Giuseppe ; Stewart, Marylou ; Holmes, David ; Schwartz, Robert S. / Porcine model of stent thrombosis : Platelets are the primary component of acute stent closure. In: Catheterization and cardiovascular diagnosis. 1996 ; Vol. 38, No. 1. pp. 38-43.
@article{7cce230069f748ba8366ef0b237865c8,
title = "Porcine model of stent thrombosis: Platelets are the primary component of acute stent closure",
abstract = "Acute stent thrombosis remains a major concern of coronary stent implantation. Animal studies using stents do not adequately mimic this clinical problem, since stent placement is rarely associated with acute closure. The purpose of this study was to develop end characterize a porcine model of stent thrombosis. Improved understanding through such a model may be useful toward preventing and treating acute stent closure. Whole blood was drawn from domestic crossbred swine one day before study. Platelets were isolated, labeled with 111-In tropolone, and reinjected within 18 hr of the study. Bilateral carotid arteries were exposed, and severes injury induced by a series of mechanical crushes. This method produced histologic injury similar to human coronary angioplasty, with medial disruption and large dissections protruding into the lumen. Stenting was performed in standard fashion with 3.5-mm JJIS stents. Local platelet deposition was measured and recorded as 111-In radioactivity using a miniaturized scintillation detector (Dosimeter Corp.) mounted directly at the artery Injury site. This measurement was made in real time at 1-min intervals. Similarly, volumetric blood flow was measured in real time by Doppler flowmeter. Eighteen arteries of nine pigs were studied. In nine arteries from nine pigs, crush Injury only was performed and monitored. In the contralateral artery, crush injury was followed immediately by placement of a 3.5-mm Palmaz-Schatz (coronary) stent. Blood flow decreased rapidly following injury in both groups and followed a cyclic pattern. Eight arteries of the crush alone and two arteries of the crush plus stent groups were totally occluded 1 hr after crush. 111-In counts normalized to baseline were significantly higher at 1 hr in both groups compared to baseline; in the stented group, counts were higher than in the unstented group. Blood flow was higher In the sleeted group than in unstented group for 1 hr. Histopathologic observation of the thrombi forming in both crush-only and crushstent injuries showed severe medial dissections with obstructing medial flap formation. The thrombi forming in both groups were highly platelet rich. This model of stent and arterial thrombosis showed rapid formation of platelet-rich thrombus, cyclic blood flow variations, and acute occlusion in 20{\%} of cases. Stent placement at arterial injury sites is associated with thrombus that Is predominantly platelet rich. Stent placement at injury sites enhances platelet deposition over crush Injury alone. Despite greater numbers of platelets, as shown by increased 111-In counts, stenting improved vessel patency. These were likely due to higher volumetric blood flow, continuous deposition, and embolization of labeled platelets.",
keywords = "111-In, acute stent closure, platelets, porcine model",
author = "Jeong, {Myung Ho} and Owen, {Whyte G.} and Staab, {Michael E.} and Srivatsa, {Sanjay S.} and Giuseppe Sangiorgi and Marylou Stewart and David Holmes and Schwartz, {Robert S.}",
year = "1996",
month = "5",
day = "1",
doi = "10.1002/(SICI)1097-0304(199605)38:1<38::AID-CCD9>3.0.CO;2-4",
language = "English (US)",
volume = "38",
pages = "38--43",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",
number = "1",

}

TY - JOUR

T1 - Porcine model of stent thrombosis

T2 - Platelets are the primary component of acute stent closure

AU - Jeong, Myung Ho

AU - Owen, Whyte G.

AU - Staab, Michael E.

AU - Srivatsa, Sanjay S.

AU - Sangiorgi, Giuseppe

AU - Stewart, Marylou

AU - Holmes, David

AU - Schwartz, Robert S.

PY - 1996/5/1

Y1 - 1996/5/1

N2 - Acute stent thrombosis remains a major concern of coronary stent implantation. Animal studies using stents do not adequately mimic this clinical problem, since stent placement is rarely associated with acute closure. The purpose of this study was to develop end characterize a porcine model of stent thrombosis. Improved understanding through such a model may be useful toward preventing and treating acute stent closure. Whole blood was drawn from domestic crossbred swine one day before study. Platelets were isolated, labeled with 111-In tropolone, and reinjected within 18 hr of the study. Bilateral carotid arteries were exposed, and severes injury induced by a series of mechanical crushes. This method produced histologic injury similar to human coronary angioplasty, with medial disruption and large dissections protruding into the lumen. Stenting was performed in standard fashion with 3.5-mm JJIS stents. Local platelet deposition was measured and recorded as 111-In radioactivity using a miniaturized scintillation detector (Dosimeter Corp.) mounted directly at the artery Injury site. This measurement was made in real time at 1-min intervals. Similarly, volumetric blood flow was measured in real time by Doppler flowmeter. Eighteen arteries of nine pigs were studied. In nine arteries from nine pigs, crush Injury only was performed and monitored. In the contralateral artery, crush injury was followed immediately by placement of a 3.5-mm Palmaz-Schatz (coronary) stent. Blood flow decreased rapidly following injury in both groups and followed a cyclic pattern. Eight arteries of the crush alone and two arteries of the crush plus stent groups were totally occluded 1 hr after crush. 111-In counts normalized to baseline were significantly higher at 1 hr in both groups compared to baseline; in the stented group, counts were higher than in the unstented group. Blood flow was higher In the sleeted group than in unstented group for 1 hr. Histopathologic observation of the thrombi forming in both crush-only and crushstent injuries showed severe medial dissections with obstructing medial flap formation. The thrombi forming in both groups were highly platelet rich. This model of stent and arterial thrombosis showed rapid formation of platelet-rich thrombus, cyclic blood flow variations, and acute occlusion in 20% of cases. Stent placement at arterial injury sites is associated with thrombus that Is predominantly platelet rich. Stent placement at injury sites enhances platelet deposition over crush Injury alone. Despite greater numbers of platelets, as shown by increased 111-In counts, stenting improved vessel patency. These were likely due to higher volumetric blood flow, continuous deposition, and embolization of labeled platelets.

AB - Acute stent thrombosis remains a major concern of coronary stent implantation. Animal studies using stents do not adequately mimic this clinical problem, since stent placement is rarely associated with acute closure. The purpose of this study was to develop end characterize a porcine model of stent thrombosis. Improved understanding through such a model may be useful toward preventing and treating acute stent closure. Whole blood was drawn from domestic crossbred swine one day before study. Platelets were isolated, labeled with 111-In tropolone, and reinjected within 18 hr of the study. Bilateral carotid arteries were exposed, and severes injury induced by a series of mechanical crushes. This method produced histologic injury similar to human coronary angioplasty, with medial disruption and large dissections protruding into the lumen. Stenting was performed in standard fashion with 3.5-mm JJIS stents. Local platelet deposition was measured and recorded as 111-In radioactivity using a miniaturized scintillation detector (Dosimeter Corp.) mounted directly at the artery Injury site. This measurement was made in real time at 1-min intervals. Similarly, volumetric blood flow was measured in real time by Doppler flowmeter. Eighteen arteries of nine pigs were studied. In nine arteries from nine pigs, crush Injury only was performed and monitored. In the contralateral artery, crush injury was followed immediately by placement of a 3.5-mm Palmaz-Schatz (coronary) stent. Blood flow decreased rapidly following injury in both groups and followed a cyclic pattern. Eight arteries of the crush alone and two arteries of the crush plus stent groups were totally occluded 1 hr after crush. 111-In counts normalized to baseline were significantly higher at 1 hr in both groups compared to baseline; in the stented group, counts were higher than in the unstented group. Blood flow was higher In the sleeted group than in unstented group for 1 hr. Histopathologic observation of the thrombi forming in both crush-only and crushstent injuries showed severe medial dissections with obstructing medial flap formation. The thrombi forming in both groups were highly platelet rich. This model of stent and arterial thrombosis showed rapid formation of platelet-rich thrombus, cyclic blood flow variations, and acute occlusion in 20% of cases. Stent placement at arterial injury sites is associated with thrombus that Is predominantly platelet rich. Stent placement at injury sites enhances platelet deposition over crush Injury alone. Despite greater numbers of platelets, as shown by increased 111-In counts, stenting improved vessel patency. These were likely due to higher volumetric blood flow, continuous deposition, and embolization of labeled platelets.

KW - 111-In

KW - acute stent closure

KW - platelets

KW - porcine model

UR - http://www.scopus.com/inward/record.url?scp=0008610803&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0008610803&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1097-0304(199605)38:1<38::AID-CCD9>3.0.CO;2-4

DO - 10.1002/(SICI)1097-0304(199605)38:1<38::AID-CCD9>3.0.CO;2-4

M3 - Article

C2 - 8722856

AN - SCOPUS:0008610803

VL - 38

SP - 38

EP - 43

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 1

ER -