헤파린 부착 관상동맥 스텐트의 스텐트 재협착 예방에 대한 효과

• Published in: The Korean journal of medicine Vol. 57; no. 1; pp. 42 - 51
• Main Authors: 강정채, Jung Chaee Kang, 박창수, Chang Soo Park, 정명호, Myung Ho Jeong, 조장현, Jang Hyun Cho, 김성희, Sung Hee Kim, 안영근, Young Keun Ahn, 박주형, Joo Hyung Park, 조정관, Jeong Gwan Cho, 박종춘, Jong Chun Park, 정상우, Sang Woo Juhng, 김준우, Joon Woon Kim
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.07.1999
• Subjects: Coronary stent; Heparin-coating; Porcine coronary artery; Restenosis
• ISSN: 1738-9364

The coronary stent reduces acute coronary arterial occlusion and late restenosis during and after coronary intervention. However, stent thrombosis and restenosis are still major limitations in widespread use of coronary stent. Local drug delivery with use of heparin-coated stent will be a new approach reducing the incidence of stent thrombosis and restenosis. In order to evaluate the effects of heparin-coated stent on stent restenosis, heparin-coated stents were compared with control stents in a porcine coronary stent restenosis model. Methods : Stent overdilation injury (stent:artery= 1.3:1.0) was performed with bare Wiktor (Group I, n=10) and heparin-coated Wiktor (Group II, n=20) stents (HEPAMEDTM, Medtronics, U.S.A.) in porcine coronary arteries. Follow-up quantitative coronary angiography (QCA) was performed at 4 weeks after stenting and histopathologic assessments of stented porcine coronary arteries were compared in both groups. Results : 1) On QCA, percent diameter stenosis was significantly higher in Group I than in Group II (16.3±6.62% vs. 9.6±5.06%, p<0.05). 2) Injury score of stented porcine coronary artery was not different in both groups (1.26±0.23 vs. 1.20±0.22). 3) Pathologic area stenosis of stented artery was higher in Group I than in Group II (41.6±12.5% vs. 27.1±9.9%, p<0.005). 4) Neointimal area was higher in Group I than in Group II (4.58±1.41 mm2 vs. 2.57±1.07 mm2, p<0.05). 5) By immunohistochemistry, proliferating cell nuclear antigen (PCNA) index was higher in Group I compared with in Group II (11.2±6.75% vs. 6.3±4.14%, p<0.05). Conclusions : Heparin-coated stent is effective in the prevention of late coronary stent restenosis in a porcine coronary stent restenosis model, which may be related with the inhibition of neointimal cell proliferation.