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Histological evaluation of vascular changes after excimer laser angioplasty for neointimal formation after bare-metal stent implantation in rabbit iliac arteries

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Abstract

Background

Excimer laser is used to treat coronary artery disease, especially in case of lesions with thrombus and in-stent restenosis (ISR). However, there are no in vivo preclinical studies that have evaluated the pathological reactions of the vessel wall after excimer laser ablation.

Methods

Bare-metal stents were placed in the external iliac arteries of six healthy rabbits. Twenty-eight days later, excimer laser ablation was performed with low-power (45 (fluency)/25 (rate)) in one side, and high-power (60/40) in the opposite side, followed by optical coherence tomography (OCT) evaluation. Rabbits were sacrificed 15 min after the procedure, and histological assessment was performed.

Results

Morphometry analysis of OCT showed similar stent and lumen size between low-power and high-power group. Histological evaluation suggested endothelial cell loss, fibrin deposition, and tissue loss. The low-power group showed significantly less pathological changes compared with the high-power group: angle of endothelial cell loss, 32.4° vs. 191.7° (interquartile range, 8.8°–131.7° vs. 125.7°–279.5°; p < 0.01); fibrin deposition, 1.1° vs. 59.6° (0.0°–70.4° vs. 31.4°–178.4°; p = 0.03); and tissue loss 0.0° vs. 18.2° (0.0°–8.7° vs. 0.0°–42.7°; p = 0.03).

Conclusions

The pathological changes in neointima were more prominent after high-power excimer laser ablation than after low-power excimer laser. To improve safety in clinical practice, understanding the pathological changes of tissues after excimer laser in lesions with ISR is essential.

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Data availability

The data that support the findings of this study are available from the corresponding author, [ST], upon reasonable request.

References

  1. Cook SL, Eigler NL, Shefer A, Goldenberg T, Forrester JS, Litvack F. Percutaneous excimer laser coronary angioplasty of lesions not ideal for balloon angioplasty. Circulation. 1991;84:632–43.

    Article  CAS  PubMed  Google Scholar 

  2. Rawlins J, Din JN, Talwar S, O’Kane P. Coronary intervention with the excimer laser: review of the technology and outcome data. Interv Cardiol. 2016;11:27–32.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Tsutsui RS, Sammour Y, Kalra A, et al. Excimer laser atherectomy in percutaneous coronary intervention: a contemporary review. Cardiovasc Revasc Med. 2021;25:75–85.

    Article  PubMed  Google Scholar 

  4. Dahm JB, Topaz O, Woenckhaus C, et al. Laser-facilitated thrombectomy: a new therapeutic option for treatment of thrombus-laden coronary lesions. Catheter Cardiovasc Interv. 2002;56:365–72.

    Article  PubMed  Google Scholar 

  5. Topaz O, Bernardo NL, Shah R, et al. Effectiveness of excimer laser coronary angioplasty in acute myocardial infarction or in unstable angina pectoris. Am J Cardiol. 2001;87:849–55.

    Article  CAS  PubMed  Google Scholar 

  6. Baumbach A, Bittl JA, Fleck E, et al. Acute complications of excimer laser coronary angioplasty: a detailed analysis of multicenter results. Coinvestigators of the U.S. and European Percutaneous Excimer Laser Coronary Angioplasty (PELCA) Registries. J Am Coll Cardiol. 1994;23:1305–13. https://pubmed.ncbi.nlm.nih.gov/8176087/.

    Article  CAS  PubMed  Google Scholar 

  7. Sintek M, Coverstone E, Bach R, et al. Excimer laser coronary angioplasty in coronary lesions: use and safety from the NCDR/CATH PCI registry. Circ Cardiovasc Interv. 2021;14:e010061.

    Article  CAS  PubMed  Google Scholar 

  8. Nakazawa G, Torii S, Ijichi T et al. Comparison of vascular responses following new-generation biodegradable and durable polymer-based drug-eluting stent implantation in an atherosclerotic rabbit iliac artery model. J Ame Heart Assoc 2016;5.

  9. Fujihara M, Kurata N, Yazu Y, et al. Clinical expert consensus document on standards for lower extremity artery disease of imaging modality from the Japan Endovascular Treatment Conference. Cardiovasc Interv Ther. 2022;37:597–612.

    Article  PubMed  Google Scholar 

  10. Fujii K, Kubo T, Otake H, et al. Expert consensus statement for quantitative measurement and morphological assessment of optical coherence tomography: update 2022. Cardiovasc Interv Ther. 2022;37:248–54.

    Article  PubMed  Google Scholar 

  11. Torii S, Nakazawa G, Ijichi T, Yoshikawa A, Ohno Y, Ikari Y. Comparison of the endothelial coverage in everolimus and zotarolimus-eluting stents in normal, atherosclerotic, and bifurcation rabbit iliac arteries. Cardiovasc Interv Ther. 2018;33:55–61.

    Article  CAS  PubMed  Google Scholar 

  12. Torii S, Yahagi K, Mori H, et al. Biologic drug effect and particulate embolization of drug-eluting stents versus drug-coated balloons in healthy swine femoropopliteal arteries. J Vasc Interv Radiol. 2018;29:1041-1049.e3.

    Article  PubMed  Google Scholar 

  13. Torii S, Yahagi K, Mori H, et al. Safety of zilver PTX drug-eluting stent implantation following drug-coated balloon dilation in a healthy swine model. J Endovasc Ther. 2018;25:118–26.

    Article  PubMed  Google Scholar 

  14. Torii S, Jinnouchi H, Sakamoto A, et al. Drug-eluting coronary stents: insights from preclinical and pathology studies. Nat Rev Cardiol. 2020;17:37–51.

    Article  CAS  PubMed  Google Scholar 

  15. Giacoppo D, Alfonso F, Xu B, et al. Drug-coated balloon angioplasty versus drug-eluting stent implantation in patients with coronary stent restenosis. J Am Coll Cardiol. 2020;75:2664–78.

    Article  CAS  PubMed  Google Scholar 

  16. Topaz O, Ebersole D, Das T, et al. Excimer laser angioplasty in acute myocardial infarction (the CARMEL multicenter trial). Am J Cardiol. 2004;93:694–701.

    Article  PubMed  Google Scholar 

  17. Nishino M, Mori N, Takiuchi S, et al. Indications and outcomes of excimer laser coronary atherectomy: efficacy and safety for thrombotic lesions—the ULTRAMAN registry. J Cardiol. 2017;69:314–9.

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank Ayako Yoshikawa (CV-Hills, Tokai University) and Shunji Amano (the Support Center for Medical Research and Education, Tokai University) for their valuable technical assistance.

Funding

This study is sponsored by Philips (Amsterdam, Netherlands). Sho Torii received research grants from Abbot Vascular Japan, Boston Scientific Japan, Medtronic, Philips Japan, and received honoraria from Philips Japan. Gaku Nakazawa is a consultant for Boston Scientific, Abbott Vascular, Terumo Corp., and Japan Medical Device Technology Co., Ltd, and received research grants from Boston Scientific, Abbott Vascular, Terumo Corp., and Japan Medical Device Technology Co., Ltd. Yuji Ikari received honoraria from Philips Japan.

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Authors and Affiliations

  1. Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan

    Hirofumi Nagamatsu, Sho Torii, Kazuki Aihara, Norihito Nakamura, Satoshi Noda, Satsuki Sekino & Yuji Ikari

  2. Division of Cardiology, Tokai University Hachioji Hospital, Tokyo, Japan

    Hirofumi Nagamatsu & Fuminobu Yoshimachi

  3. Division of Clinical Engineering, Tokai University Hachioji Hospital, Tokyo, Japan

    Keigo Nakazawa

  4. Department of Cardiology, Kinki University Faculty of Medicine, Osaka, Japan

    Gaku Nakazawa

Authors
  1. Hirofumi Nagamatsu
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  2. Sho Torii
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  3. Kazuki Aihara
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  4. Keigo Nakazawa
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  5. Norihito Nakamura
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  6. Satoshi Noda
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  7. Satsuki Sekino
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  8. Fuminobu Yoshimachi
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  9. Gaku Nakazawa
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  10. Yuji Ikari
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Correspondence to Sho Torii.

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Nagamatsu, H., Torii, S., Aihara, K. et al. Histological evaluation of vascular changes after excimer laser angioplasty for neointimal formation after bare-metal stent implantation in rabbit iliac arteries. Cardiovasc Interv and Ther 38, 223–230 (2023). https://doi.org/10.1007/s12928-022-00905-8

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  • DOI: https://doi.org/10.1007/s12928-022-00905-8

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