Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492010000200006
Jornal Vascular Brasileiro
Artigo Original

Análise morfométrica da carótida de suínos submetidos a angioplastia com ou sem implante de stent de cromo-cobalto

Morphometric analysis of swine carotid artery angioplasty with or without cobalt-chromium stent implantation

João Luiz de Lara Elesbão; Adamastor Humberto Pereira; Marco Aurélio Grüdtner; Fabiola Meyer

http://dx.doi.org/10.1590/S1677-54492010000200006 J Vasc Bras, vol.9, n2, p.40-46, 2010
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Resumo

Contexto: A hiperplasia intimal é a reação tardia mais comum decorrente da angioplastia. O uso de stents de cromo-cobalto é bem estudado na circulação coronariana, porém não há muitos estudos que abordem o uso desses stents nas circulações carotídea e periférica. Objetivo: Analisar mediante morfometria a reação intimal presente na artéria carótida de suínos submetidos a angioplastia isoladamente e a angioplastia seguida de implante de stent de cromo-cobalto. Materiais e métodos: Em oito suínos, foi realizada angioplastia da artéria carótida comum direita e angioplastia seguida de implante de um stent de cromo-cobalto na artéria carótida comum esquerda. Após 4 semanas, os animais foram submetidos a eutanásia para a retirada de amostras de tecido arterial e preparo de lâminas histológicas. As imagens das lâminas foram digitalizadas e analisadas por programa de morfometria digital. A análise estatística foi realizada através da média e desvio padrão das áreas em cada grupo, utilizando-se o Teste t de Student. O valor de p < 0,05 foi considerado significativo. Resultados: O implante do stent provocou maior grau de hiperplasia comparado à angioplastia isolada. A diferença em resposta ao implante de stent foi estatisticamente significativa quando as áreas do lúmen, da lâmina elástica interna e da lâmina elástica externa foram comparadas entre os dois grupos. Não se observou diferença significativa quando se realizou a comparação entre as camadas médias dos dois grupos. Conclusão: O implante de stent de cromo-cobalto gerou um espessamento intimal maior do que o produzido apenas pela angioplastia, porém ele não foi suficiente para reduzir o lúmen arterial.

Palavras-chave

Angioplastia, stents, suínos

Abstract

Background: Intimal hyperplasia is the most common delayed response to angioplasty. The use of cobalt-chromium stents is well studied in the coronary circulation; however, there are few studies on their use in the carotid and peripheral circulation. Objective: To analyze the intimal reaction in a swine carotid artery undergoing simple angioplasty and angioplasty followed by implantation of cobalt-chromium stent. Materials and methods: We carried out angioplasty in the right common carotid artery and angioplasty with cobalt-chromium stent in the left common carotid artery in eight swine. Four weeks later, all animals were sacrificed for arterial tissue sampling and preparation of histological slides. Slide images were scanned and analyzed using a digital morphometry program. Statistical analysis was performed by mean values and standard deviations of the areas in each group, using the Student's t test. A p value of < 0.05 was considered significant. Results: Angioplasty with cobalt-chromium stent implantation resulted in a higher degree of hyperplasia compared with simple angioplasty. The difference was statistically significant when the lumen area, the internal elastic lamina area, and the external elastic lamina area were compared between the two groups. No statistically significant difference was found when the media layers of both groups were compared. Conclusion: Cobalt-chromium stent implantation resulted in more intimal hyperplasia than simple angioplasty, however the stent was not enough to reduce the arterial lumen.

Keywords

Angioplasty, stents, swine

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