Abstract
BackgroundPercutaneous coronary intervention is among the most common therapeutic interventions in cardiology. This procedure may, however, be associated with a rare, though life-threatening complication: acute coronary perforation (CP). CP is primarily treated using covered stents, which are made of bare metal stents with a polytetrafluoroethylene (PTFE) or polyurethane coating. These stents’ major limitations include higher rates of thrombus formation and restenosis. Hence, there is a still unmet need for new stents regarding their design and composition. Or, to test new covered stent designs, the rabbit iliac artery has become the best-established animal model. This study sought to present a preclinical animal approach designed to test covered stents that are utilized following vessel perforation.MethodsThe animal experiments were performed using New Zealand white rabbits, each weighting 3.5–4.5 kg. The animal models described herein relied on the three most common clinical causes for CP, such as guidewire-induced, balloon catheter bursting, and device oversizing. Moreover, the sealing capacity of covered stent grafts was assessed for each of these models by means of angiography.ResultsWe herein report a rabbit iliac artery perforation model using three different types of vessel perforation that closely mimic the clinical setting, such as guidewire-induced, balloon catheter rupture, and device oversizing. Using the same rabbit iliac perforation model, we additionally assessed the sealing capacity of a covered stent graft for each model.ConclusionsThe novel rabbit iliac artery perforation models, as described in this report, represent promising animal testing approaches. While their setting is very similar to the real-life context encountered in humans, all three models are based on an animal model that is ideally suited for evaluating the sealing capacity and performance of new medical devices for humans.
Highlights
Percutaneous coronary intervention is among the most common therapeutic interventions in cardiology
We have presented a preclinical animal approach designed to test covered stents after vessel perforation, based on the three most common clinical causes of vessel perforation: guidewire-induced, balloon catheter bursting, and device oversizing
After 20 min, the unconscious state of the animal was deep enough to begin shaving the throat and initiate the anesthetic infusion consisting of the ketamine–xylazine mixture [50 mg ketamine and 5 mg xylazine per kg body weight added to a 100-mL sodium chloride (NaCl) infusion bag; Freeflex 100 mL Sodium chloride (NaCl) 0.9, Fresenius Kabi, Bad Homburg, Germany], via the outer ear vein (26 G permanent intravenous catheter, BD Neoflon, Becton–Dickinson, Heidelberg, Germany)
Summary
Percutaneous coronary intervention is among the most common therapeutic interventions in cardiology This procedure may, be associated with a rare, though life-threatening complication: acute coronary perforation (CP). CP is primarily treated using covered stents, which are made of bare metal stents with a polytetrafluoroethylene (PTFE) or polyurethane coating. These stents’ major limitations include higher rates of thrombus formation and restenosis. This study sought to present a preclinical animal approach designed to test covered stents that are utilized following vessel perforation. Covered stents are usually made of bare metal stents with a polytetrafluoroethylene (PTFE) or polyurethane coating These stents display a 90% success rate for the treatment of perforation [2, 6]. Their limitations, especially in case of bulky PTFE-covered stents, include significantly higher rates of thrombus formation and restenosis, compared to regular stents [6, 7]
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