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目的:应用光学相干断层成像(OCT)、病理和扫描电镜评价猪冠状动脉佐他莫司洗脱支架(ZES)术后早期(7天、14天、28天)新生内膜覆盖情况。方法:18只中华小型猪随机分为7天组、14天组和28天组,每组6只,每只猪于右冠状动脉置入一枚佐他莫司洗脱支架,3组实验动物分别于术后7天、14天及28天时进行OCT检查,观察支架表面新生内膜覆盖情况,并取支架段冠状动脉进行病理组织学检查及扫描电镜观察。结果:用OCT观察3个时间段支架表面新生内膜情况,7天组为(61.3±37.7)μm,14天组为(132.6±103.3)μm,28天组为(244.3±282.3)μm,3组间差异有统计学意义(P<0.001),新生内膜覆盖率7天组为(53.62±2.49)%,28天组达到(94.88±2.93)%,病理提示7天时新生内膜以炎性细胞、红细胞、血小板为主,28天时以平滑肌细胞、炎性细胞和血管内皮细胞为主。结论:OCT在支架术后7天即能清晰观察到新生内膜覆盖情况,佐他莫司洗脱支架术后28天大多数支架丝被新生内膜覆盖。
OBJECTIVE: To evaluate the neointimal coverage during the early (7 days, 14 days, 28 days) postoperative period of porcine coronary artery ZETA amiodarone stent (ZES) by optical coherence tomography (OCT), pathology and scanning electron microscopy. Methods: Eighteen Chinese miniature pigs were randomly divided into 7 days group, 14 days group and 28 days group with 6 animals in each group. One pig received the Zotarolimus stent in the right coronary artery. Three experimental animals OCT examination was performed at 7 days, 14 days and 28 days after operation respectively. The neointimal coverage was observed on the scaffold surface. The coronary artery of the stent was examined by histopathology and scanning electron microscopy. Results: Neointimal hyperplasia was observed on the scaffolds at three time points in OCT group, which was (61.3 ± 37.7) μm in 7 days, (132.6 ± 103.3) μm in 14 days, and (244.3 ± 282.3) μm in 28 days (53.62 ± 2.49)% in the neointimal hyperplasia group and (94.88 ± 2.93)% in the 28 - day group, and the neointimal hyperplasia was found to be inflammatory Cells, erythrocytes, and platelets were the major components of smooth muscle cells, inflammatory cells and vascular endothelial cells at 28 days. CONCLUSIONS: Neointimal coverage was clearly observed at OCT 7 days after stenting. Most of the stent filaments were covered with neointimal formation 28 days after the zotarolimus-eluting stents.