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Effects of stenting on adjacent vascular distensibility and neointima formation: role of nitric oxide

University of Innsbruck School of Medicine, Division of Cardiology, Innsbruck, Austria

Philip S Tsao

Stanford University Medical Center, Division of Cardiovascular Medicine, Stanford, CA, USA

Michael Ward

Stanford University Medical Center, Division of Cardiovascular Medicine, Stanford, CA, USA

Moto Hayase

Stanford University Medical Center, Division of Cardiovascular Medicine, Stanford, CA, USA

Josef Niebauer

Leipzig Heart Center, Department of Internal Medicine and Cardiology, Leipzig, Germany

John P Cooke

Stanford University Medical Center, Division of Cardiovascular Medicine, Stanford, CA, USA

Alan C Yeung

Stanford University Medical Center, Division of Cardiovascular Medicine, Stanford, CA, USA, alanyeung{at}cvmed.stanford.edu

Intravascular stents increase long-term patency but their effects on the vascular mechanics of adjacent segments have not been studied. In this study, stents were deployed in the rabbit abdominal aorta after 1 week of normal diet, 1% cholesterol diet or 1% cholesterol diet with l-nitro arginine (l-NA 60 mg/l water). Intravascular ultrasound showed a small distal decrease in vessel distensibility (area/pressure * 100) before stenting. Distensibility was almost abolished by stenting (0.12 ± 0.01, p 0.001), but was increased proximal to the stent and decreased distal to the stent both acutely (proximal: 1.18 ± 0.10 vs distal: 0.65 ± 0.06, p 0.001), and at 4 weeks (proximal: 1.05 ± 0.08 vs distal: 0.37 ± 0.07, p 0.001). Nitric oxide (NO) activity was enhanced proximal to and within the stent, and remained constant distal to the stent, (versus control, proximal: 57 ± 23%, stent: 136 ± 35%, distal: 2 ± 12%, p 0.01). The I/M ratio was significantly higher proximal to and within the stent than in the distal segment (proximal: 0.40 ± 0.10, stent: 0.37 ± 0.12, distal: 0.12 ± 0.11, p 0.01). NO blockade with l-NA prevented hyperdistensibility proximally, and significantly increased the I/M ratio within the stent and distally (stent: 0.81 ± 0.19, distal: 0.30 ± 0.10, p 0.05) but not proximally (0.38 ± 0.09). In conclusion, aortic stenting increases proximal vascular distensibility and intimal lesion formation. Nitric oxide blockade augments intimal growth within but not proximal to the stent.

Key Words: distensibility • nitric oxide • stent

Vascular Medicine, Vol. 6, No. 3, 139-144 (2001)
DOI: 10.1177/1358836X0100600303


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