First Reported Case of Neointimal Hyperplasia in the Midportion of a Polytetrafluoroethylene Dialysis Graft

SummaryRestenosis following coronary angioplasty is thought to result from migration and proliferation of medial smooth muscle cells. However, the factors that initiate this proliferation are still unknown. In a rabbit model of carotid artery injury, we tested the hypothesis that activated platelets and leucocytes might contribute to the development of neointimal hyperplasia. Following arterial injury, rabbits received either no treatment, R15.7, a monoclonal antibody against the leucocyte CD ll/CD 18 adhesion complex, aurintricarboxylic acid (ATA), a sub stance that inhibits platelet glycoprotein Ib-von Willebrand factor interaction, or the combination of R15.7 and ATA. After 21 days, the extent of neointimal hyperplasia was evaluated by planimetry on histological arterial sections. The area of neointima averaged 0.51 ±0.07 mm2 in control animals and it was significantly reduced by administrationof either R15.7 or ATA alone to 0.12 ± 0.05 and 0.20 ±0.01 mm2, respectively (p <0.05 vs controls for both groups). The animals that received the combination of R15.7 and ATA showed a further reduction in neointimal hyperplasia, as compared to animals that received ATA alone (p <0.05 vs ATA alone). These data indicate that platelets and leucocytes play animportant role in the pathophysi ology of neointimal hyperplasia in this experimental model. Interven tions that reduce platelet and leucocyte adhesion to vessel wall might have beneficial effects in reducing restenosis following coronary angioplasty.

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Continuous Subcutaneous Angiopeptin Treatment Significantly Reduces Neointimal Hyperplasia in a Porcine Coronary In-Stent Restenosis Model

Circulation ◽

10.1161/01.cir.95.2.449 ◽

1997 ◽

Vol 95 (2) ◽

pp. 449-454 ◽

Cited By ~ 20

Author(s):

Mun K. Hong ◽

Kenneth M. Kent ◽

Roxana Mehran ◽

Gary S. Mintz ◽

Fermin O. Tio ◽

...

Keyword(s):

Neointimal Hyperplasia ◽

Stent Restenosis ◽

In Stent Restenosis

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The Smooth Muscle Myosin Heavy Chain Cre-loxp System Definitively Demonstrates Medial Smooth Muscle Involvement in Neointimal Hyperplasia With Ligation and Wire Injury Models

Journal of Surgical Research ◽

10.1016/j.jss.2010.11.483 ◽

2011 ◽

Vol 165 (2) ◽

pp. 254-255

Author(s):

M.S. Hong ◽

T. Gupta ◽

S.A. Berceli ◽

Z. Jiang

Keyword(s):

Smooth Muscle ◽

Myosin Heavy Chain ◽

Heavy Chain ◽

Neointimal Hyperplasia ◽

Smooth Muscle Myosin ◽

Muscle Involvement ◽

Injury Models ◽

Muscle Myosin

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Evaluation of a Targeted Drug‐Eluting Intravascular Nanotherapy to Prevent Neointimal Hyperplasia in an Atherosclerotic Rat Model

Advanced NanoBiomed Research ◽

10.1002/anbr.202000093 ◽

2021 ◽

pp. 2000093

Author(s):

Emily R. Newton ◽

David C. Gillis ◽

Kui Sun ◽

Brooke R. Dandurand ◽

Robin Siletzky ◽

...

Keyword(s):

Rat Model ◽

Neointimal Hyperplasia ◽

Drug Eluting ◽

Targeted Drug

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Neutrophil Elastase Promotes Neointimal Hyperplasia by Targeting TLR4‐NFкB Signalling

British Journal of Pharmacology ◽

10.1111/bph.15583 ◽

2021 ◽

Author(s):

Mei Yang ◽

Qishan Chen ◽

Li Mei ◽

Guanmei Wen ◽

Weiwei An ◽

...

Keyword(s):

Neutrophil Elastase ◽

Neointimal Hyperplasia

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Multifunctional Biodegradable Vascular PLLA Scaffold with Improved X-ray Opacity, Anti-Inflammation, and Re-Endothelization

Polymers ◽

10.3390/polym13121979 ◽

2021 ◽

Vol 13 (12) ◽

pp. 1979

Author(s):

Ho In Lee ◽

Yun Heo ◽

Seung-Woon Baek ◽

Da-Seul Kim ◽

Duck Hyun Song ◽

...

Keyword(s):

Lactic Acid ◽

Inflammatory Responses ◽

Neointimal Hyperplasia ◽

Film Surface ◽

High Mechanical Property ◽

X Ray ◽

Stent Restenosis ◽

X Ray Computed ◽

Hydrolysis Of

Poly(L-lactic acid) (PLLA) has been used as a biodegradable vascular scaffold (BVS) material due to high mechanical property, biodegradability, and biocompatibility. However, acidic byproducts from hydrolysis of PLLA reduce the pH after the surrounding implanted area and cause inflammatory responses. As a result, severe inflammation, thrombosis, and in-stent restenosis can occur after implantation by using BVS. Additionally, polymers such as PLLA could not find on X-ray computed tomography (CT) because of low radiopacity. To this end, here, we fabricated PLLA films as the surface of BVS and divided PLLA films into two coating layers. At the first layer, PLLA film was coated by 2,3,5-triiodobenzoic acid (TIBA) and magnesium hydroxide (MH) with poly(D,L-lactic acid) (PDLLA) for radiopaque and neutralization of acidic environment, respectively. The second layer of coated PLLA films is composed of polydopamine (PDA) and then cystamine (Cys) for the generation of nitric oxide (NO) release, which is needed for suppression of smooth muscle cells (SMCs) and proliferation of endothelial cells (ECs). The characterization of the film surface was conducted via various analyses. Through the surface modification of PLLA films, they have multifunctional abilities to overcome problems of BVS effectively such as X-ray penetrability, inflammation, thrombosis, and neointimal hyperplasia. These results suggest that the modification of biodegradable PLLA using TIBA, MH, PDA, and Cys will have important potential in implant applications.

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The comparison of the chronic-phase vascular healing between bioabsorbable and durable polymer drug eluting stent by using optical coherence tomography

European Heart Journal ◽

10.1093/ehjci/ehaa946.2472 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

Y Yamakami ◽

S Kimura ◽

K Hara ◽

M Ohmori ◽

R Tateishi ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Acute Coronary Syndrome ◽

Clinical Presentation ◽

Neointimal Hyperplasia ◽

Chronic Phase ◽

Drug Eluting Stents ◽

Coronary Syndrome ◽

Durable Polymer ◽

Drug Eluting

Abstract Background Bioabsorbable polymer drug eluting stents (BP-DESs) were designed to reduce a vascular inflammatory reaction compared to durable polymer drug eluting stents (DP-DESs). However, few studies have compared vascular responses to BP-DESs and DP-DESs. Methods We enrolled 88 consecutive patients with single culprit coronary artery lesions (31 lesions with acute coronary syndrome) undergoing a single stent-implantation. BP-DESs and DP-DESs were implanted in 50 (57%) and 38 patients (43%), respectively. All lesions underwent optical coherence tomography examination at chronic phase and intrastent OCT findings at the follow-up were evaluated in every 1-mm cross-sections (CSs). Results A total of 1887 CSs (BP-DES: 1096, DP-DES: 791) were analyzed. The median period of follow-up OCT was 293 (250–374) days. There were no differences in the patient, lesion, and initial clinical presentation of acute coronary syndrome (ACS). BP-DESs had significantly higher percent neointimal hyperplasia area, defined as neointimal hyperplasia area divided by stent area x 100 (18.4±9.0% vs. 16.1±9.9%, p<0.001), fewer malapposed struts (1.7% vs. 3.9%, p=0.005), fewer uncovered struts (3.6% vs. 5.8%, p=0.02) but higher frequency of superficial low intensity neointima (LIN) (7.7% vs. 3.4%, p<0.001). Multivariate logistic analysis showed that BP-DES (OR: 2.5, 95% CI: 1.49–4.08, p<0.001) and the initial clinical presentation of ACS (OR: 2.31, 95% CI: 1.47–3.62, p<0.001) are independent predictive factors for LIN. Conclusion BP-DESs showed homogenous neointimal growth and complete stent coverage quantitatively. Meanwhile, the significant relationships of BP-DES with LIN may suggest that the neointimal quality remains immature in BP-DESs in this period. Funding Acknowledgement Type of funding source: None

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p27–p16 Chimera: A Superior Antiproliferative for the Prevention of Neointimal Hyperplasia

Molecular Therapy ◽

10.1006/mthe.2000.0239 ◽

2001 ◽

Vol 3 (1) ◽

pp. 8-13 ◽

Cited By ~ 12

Author(s):

James G. McArthur ◽

Husheng Qian ◽

Dianne Citron ◽

Gautam G. Banik ◽

Lou Lamphere ◽

...

Keyword(s):

Neointimal Hyperplasia

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In Silico Prediction of the Mechanobiological Response of Arterial Tissue: Application to Angioplasty and Stenting

Journal of Biomechanical Engineering ◽

10.1115/1.4004492 ◽

2011 ◽

Vol 133 (8) ◽

Cited By ~ 23

Author(s):

Colin J. Boyle ◽

Alexander B. Lennon ◽

Patrick J. Prendergast

Keyword(s):

Smooth Muscle ◽

Smooth Muscle Cell ◽

Muscle Cell ◽

Time Course ◽

Neointimal Hyperplasia ◽

Cell Activity ◽

Tissue Response ◽

Cell Phenotype ◽

Modeling Approach ◽

Arterial Tissue

One way to restore physiological blood flow to occluded arteries involves the deformation of plaque using an intravascular balloon and preventing elastic recoil using a stent. Angioplasty and stent implantation cause unphysiological loading of the arterial tissue, which may lead to tissue in-growth and reblockage; termed “restenosis.” In this paper, a computational methodology for predicting the time-course of restenosis is presented. Stress-induced damage, computed using a remaining life approach, stimulates inflammation (production of matrix degrading factors and growth stimuli). This, in turn, induces a change in smooth muscle cell phenotype from contractile (as exists in the quiescent tissue) to synthetic (as exists in the growing tissue). In this paper, smooth muscle cell activity (migration, proliferation, and differentiation) is simulated in a lattice using a stochastic approach to model individual cell activity. The inflammation equations are examined under simplified loading cases. The mechanobiological parameters of the model were estimated by calibrating the model response to the results of a balloon angioplasty study in humans. The simulation method was then used to simulate restenosis in a two dimensional model of a stented artery. Cell activity predictions were similar to those observed during neointimal hyperplasia, culminating in the growth of restenosis. Similar to experiment, the amount of neointima produced increased with the degree of expansion of the stent, and this relationship was found to be highly dependant on the prescribed inflammatory response. It was found that the duration of inflammation affected the amount of restenosis produced, and that this effect was most pronounced with large stent expansions. In conclusion, the paper shows that the arterial tissue response to mechanical stimulation can be predicted using a stochastic cell modeling approach, and that the simulation captures features of restenosis development observed with real stents. The modeling approach is proposed for application in three dimensional models of cardiovascular stenting procedures.

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