Differences in vascular response between balloon overstretch and stent overexpansion in nonatherosclerotic porcine coronary arteries

Yoshiaki Mitsutake, Jörg Reifart, Wook Bum Pyun, Jennifer K. Lyons, Tobias Deuse, Sonja Schrepfer, Fumiaki Ikeno

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Which preclinical models are best suited for restenosis research remains uncertain. Here we compared the restenotic responses after balloon or stent overstretch injury in a porcine coronary artery. A total of 30 coronary lesions in 5 pigs were treated by balloon overdilatation or oversized stent implantation at various balloon-to-artery (B:A) ratios. Four weeks later, the lesions were examined in vivo by using coronary angiography, intravascular ultrasound, and optical coherence tomography (OCT). At follow-up, the lumen area stenosis and plaque burden at the minimal lumen area site were greater in stented sites than in balloon injury site (lumen area stenosis, 21.7 ± 8.9% compared with 32.8 ± 12.1%; plaque burden, 30.1% ± 10.1% compared with 44.7% ± 10.1%, respectively). The remodeling index was significantly smaller for the balloon-injury group than the stent group (0.86 ± 0.11 compared with 1.00 ± 0.04). Only the stent group that was dilated at a high B:A ratio resulted in increased plaque burden. In the balloon-injury sites, high B:A ratios were significantly associated with greater negative remodeling. Tissue morphology assessment by OCT revealed that the predominant pattern in balloon injury sites was homogeneous, whereas that in stented sites was a layered to heterogeneous pattern. Neointimal proliferation was significantly greater after oversized stenting than after balloon overstretch injury. Together these findings suggest that stent overexpansion of porcine coronary arteries might be appropriate for researching restenosis than is the balloon overstretch injury model.

Original languageEnglish
Pages (from-to)350-355
Number of pages6
JournalComparative Medicine
Issue number4
StatePublished - Jul 2017

Bibliographical note

Funding Information:
This study was indirectly funded by Hamburg University. Yoshiaki Mitsutake received grant support from the International Research Fund for Subsidy of Kyushu University School of Medicine Alumni.

Publisher Copyright:
Copyright 2017 by the American Association for Laboratory Animal Science.


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