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Effect of balloon angioplasty and stenting following clips vs suture arterial stenosis: an experimental study.

BACKGROUND
Comparative evaluation of balloon angioplasty following intravascular stenting after experimental stenoses caused by arterial reconstruction with vascular clips and conventional sutures.


MATERIALS AND METHODS
A total of 24 arteriotomies were carried out at the carotid and common iliac arteries of pigs following a 10 mm longitudinal arteriotomy and provocation of stenosis. Twelve of the arteries were reconstructed with vascular clips and 12 with conventional suture. Ultrasonography revealed stenosis fluctuating from 60-95% (PSV: 1.8-3.5 m/sec EDV: 1.3-1.47 m/sec PSV ratio > 3.5). After 8 weeks, following digital subtraction angiography, which revealed > 50% stenosis in all of the cases, balloon angioplasty followed by placement of intravascular stent was carried out.


RESULTS
All the angioplasties remained angiographically and macroscopically patent two months after without thrombus formation. Rupture during dilatation occurred in one of the sutured cases. Histologically no degenerative changes, necrosis or remarkable intimal thickness were observed in either method. Focal inflammatory reaction was seen in 2 sutured and in 1 clipped cases while intimal ulceration was observed in 2 sutured cases. All cases with clips presented an intact endothelial surface.


CONCLUSION
Early experimental results suggested that arterial stenosis provoked by clipped reconstruction could be managed successfully by balloon angioplasty followed by placement of intravascular stent.