The relationship of lumen diameter and neointimal hyperplasia with inflation pressure.

BACKGROUND The mechanical stretch injury imposed by the intravascular intervention contributes to neointimal hyperplasia. Lessening of this damage without the compromise of luminal dilation could be an alternative way to alleviate restenosis. OBJECTIVE We aimed to assess the relationship of lumen diameter and neointimal hyperplasia with inflation pressure using color Doppler ultrasound-guided balloon dilation. METHODS The anteroposterior diameter of the given aortic segment in rabbits was measured by ultrasonography to ensure the similar original diameter. Then they were assigned into three groups with the inflation force at 1, 5, 10 atmosphere pressure (atm), respectively. Balloon dilation and injury of the given aortic segment were performed. Two weeks later, all rabbits were euthanized for histologic evaluation. RESULTS After operation, the lumen diameter of each group enlarged significantly (P< 0.05) with a similar rate of change. However, neointimal area, circumference and hepatocyte growth factor (HGF) positive cells in group with 1 atm were significantly less than those of the other two (P< 0.05). Maximal neointima thickness increased significantly with the elevation of the inflation pressure (P< 0.05). CONCLUSIONS Based on sufficient dilation of the balloon, the balloon inflated with the less pressure caused the similar increase in lumen diameter as the higher pressure but the less neointimal hyperplasia and HGF positive cells.

[1]  J. Suárez de Lezo,et al.  Direct bioresorbable vascular scaffold implantation: Feasibility and midterm results , 2016, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[2]  S. Gatti,et al.  Cellular and molecular mechanisms of HGF/Met in the cardiovascular system. , 2015, Clinical science.

[3]  L. Salman,et al.  Measurement of Vessel Diameter During Angioplasty: Are We Accurately Performing This Task? , 2014, Seminars in dialysis.

[4]  A. Banning,et al.  IVUS-guided high-pressure non-compliant balloon dilation to treat in-DES restenosis. , 2014, The Journal of invasive cardiology.

[5]  Zhe Tang,et al.  Cutting-balloon angioplasty before drug-eluting stent implantation for the treatment of severely calcified coronary lesions , 2014, Journal of geriatric cardiology : JGC.

[6]  R. Virmani,et al.  Biological responses in stented arteries. , 2013, Cardiovascular research.

[7]  G. Sarno,et al.  Effect of Stent Inflation Pressure and Post-Dilatation on the Outcome of Coronary Artery Intervention. A Report of More than 90 000 Stent Implantations , 2013, PloS one.

[8]  M. Taupitz,et al.  Inhibition of neointimal proliferation after bare metal stent implantation with low-pressure drug delivery using a paclitaxel-coated balloon in porcine coronary arteries , 2012, Clinical Research in Cardiology.

[9]  Kevin Croce,et al.  Vascular inflammation and repair: implications for re-endothelialization, restenosis, and stent thrombosis. , 2011, JACC. Cardiovascular interventions.

[10]  S. Trerotola,et al.  Stent graft versus balloon angioplasty for failing dialysis-access grafts. , 2010, The New England journal of medicine.

[11]  S. Unger,et al.  Secondary autogenous arteriovenous fistulas in the "fistula first" era: results of a longterm prospective study. , 2009, Journal of the American College of Surgeons.

[12]  L. Garcia,et al.  Peripheral atherectomy: a critical review. , 2007, Journal of interventional cardiology.

[13]  Mei Zhang,et al.  Prediction of atherosclerotic plaque ruptures with high-frequency ultrasound imaging and serum inflammatory markers. , 2007, American journal of physiology. Heart and circulatory physiology.

[14]  R. Virmani,et al.  Preclinical restenosis models and drug-eluting stents: still important, still much to learn. , 2004, Journal of the American College of Cardiology.

[15]  R. Beyar Novel Approaches to Reduce Restenosis , 2004, Annals of the New York Academy of Sciences.

[16]  A. Curcio,et al.  Rat carotid artery dilation by PTCA balloon catheter induces neointima formation in presence of IEL rupture. , 2002, American Journal of Physiology. Heart and Circulatory Physiology.

[17]  M. Dake,et al.  Effect of human recombinant vascular endothelial growth factor165 on progression of atherosclerotic plaque. , 2001, Journal of the American College of Cardiology.

[18]  M. Condorelli,et al.  Smooth muscle cell proliferation is proportional to the degree of balloon injury in a rat model of angioplasty. , 1995, Circulation.

[19]  E. Gherardi,et al.  Hepatocyte growth factor/scatter factor and MET are involved in arterial repair and atherogenesis. , 2006, The American journal of pathology.