Reliable models of severe coronary stenosis in porcine coronary arteries: Lesion induction by high temperature or copper stent

Severe, chronic, and nonfatal stenoses in coronary arteries have been difficult to induce consistently in large animals. Availability of such a model would have practical applications, including understanding the pathophysiology of coronary stenoses and testing new interventional devices. Current methods of producing stenosis typically require an open chest preparation, are time-consuming and expensive. The purpose of this study was to report two reliable methods for creating severely stenotic lesions percutaneously in a porcine model without the need for an atherogenic diet. Two methods for producing severe coronary stenoses in pigs were found: (I) thermal balloon angioplasty at high temperature (80°C), and (2) implantation of elemental copper stents. Both were performed using a carotid artery cutdown. Pigs were euthanized, the hearts perfusion fixed, and arteries examined histologically. Thermal balloon angioplasty injury produced lesions with mean histopathological stenosis of 67% ± 27% and mean angiographic stenosis of 70% ± 21%. Histopathological examination showed medial necrosis, adventitial fibrosis, and occasional calcification of the external elastic lamina. Copper stent deployment created a mean histopathological stenosis of 81% ± 22% and mean angiographic stenosis of 84% ± 17%. Histopathological evaluation revealed inflammatory lesions with destruction of the elastic laminas and gross enlargement of vessel diameter. Two practical methods that reliably create severe coronary artery stenoses use intracoronary heat or copper stent implant. These lesions can be used for testing coronary interventional and diagnostic devices. These models generate lesions that form rapidly, use standard percutaneous techniques, and do not require intrathoracic surgery or atherogenic diets.