Effect of antithrombotic agents on the patency of PTFE-Covered stents in the inferior vena cava: An experimental study
- 62 Downloads
Purpose: To evaluate the efficacy of antithrombotic agents in the prevention of stenosis of polytetrafluororethylene (PTFE)-covered stents in the venous system.
Methods: Spiral Z stents covered with PTFE (PTFE-covered stents) were placed in the inferior vena cava (IVC) of 34 dogs. Nineteen dogs, used as a control group, were sacrificed at 2, 4, and 12 weeks. Fifteen dogs, previously given antithrombotic agents [cilostazol (n=5), warfarin potassium (n=5), cilostazol plus warfarin potassium (n=5)] were sacrificed at 4 weeks, and then examined angiographically and histopathologically. The effect of the antithrombotic agents was compared between groups.
Results: The patency rate of the antithrombotic agent group was 93% (14/15), which was higher than the control group rate of 63% (12/19). The mean stenosis rate of the patent stent at both ends and at the midportion was lower at 4 weeks in the antithrombotic agent group than in the control group. In particular, the mean stenosis rate in the cilostazol plus warfarin potassium group was significantly lower than the control group (Tukey’s test, p < 0.05). The mean neointimal thickness of the patent stent at both ends and at the midportion was thinner at 4 weeks in the antithrombotic agent group than in the control group. In particular, the thickness of the neointima in the cilostazol plus warfarin potassium group was significantly decreased when compared with the control group (Tukey’s test p < 0.05). At 4 weeks, endothelialization in the antithrombotic agent group tended to be almost identical to that in the control group.
Conclusion: The present study suggests that administration of an antithrombotic agent is an effective way of preventing the stenosis induced by a neointimal thickening of PTFE-covered stents in the venous system.
Key wordsInferior vena cava Grafts and prostheses Thrombotic occlusion Antithrombotic drugs
Unable to display preview. Download preview PDF.
- 4.Makutani S, Maeda M, Yoshioka T, Kichikawa K, Matsuo N, Ohishi H, Uchida H (1995) Usefulness of metallic stent for venous obstruction. Jpn J Phlebol 6:221–228Google Scholar
- 6.Yoshioka T, Kitano S, Makutani S, Maeda M, Kichikawa K, Kubota Y, Ohishi H, Uchida H (1995) Management of portal vein thrombosis of hepatocellular carcinoma with covered metallic stent. IVR 10(3):327–330Google Scholar
- 8.Takahashi S, Nakai T, Miyabo S (1992) Effect of cilostazol and PGE1 on proliferation of rat arterial smooth muscle cells in culture. J Jpn Coll Angiol 32:651–655Google Scholar
- 10.Ishimaru S, Fujiwara Y, Domeki K, Horiguchi T, Furukawa K, Takahashi M (1977) Defibrinogenation therapy in venous reconstructive surgery using ePTFE graft: Its possibilities and limitations. J Jpn Coll Angiol 17(5):515–520Google Scholar
- 11.Kimura T (1977) The process of pseudointimal formation in the expanded polytetrafluoroethylene graft inserted into the venous system. J Jpn Coll Angiol 17(3):273–281Google Scholar
- 12.Yasutake T (1977) Expanded polytetrafluoroethylene (Gore Tex) graft for caval replacement in the dog: Evaluation of patency and neointima. J Jpn Coll Angiol 17(6):667–676Google Scholar
- 13.Ohkuma T (1984) Replacement of the portal vein with e-PTFE vascular graft: Experimental study on the process of endothelialization. J Jpn Surg Soc 85:1558–1569Google Scholar
- 14.Ghidoni JJ, Liotta D, Hall CW, Adams JG, Lechter A, Barrionueva M, O’Neal RM, DeBakey ME (1968) Healing of pseudointimas in velour-lined impermeable arterial prosthesis. Am J Pathol 53:375–389Google Scholar