Gunnar Tepe, Presenter: Nothing to Disclose

Frank Reddig, Abstract Co-Author: Nothing to Disclose

Michael Laule, Abstract Co-Author: Nothing to Disclose

Peter Muschick, Abstract Co-Author: Nothing to Disclose

Claus Detlef Claussen MD, Abstract Co-Author: Nothing to Disclose

Stephan Hoyt Duda MD, Abstract Co-Author: Nothing to Disclose

Stent implantation in the carotid artery [CA] has been shown to be feasible for treatment of CA stenosis. Even the restenosis rate is reported to be much lower than in the coronary and peripheral arteries problems may rise with increasing numbers of treated patients.

Eight pigs were randomly assigned to receive a sirolimus-eluting nitinol self-expanding stent (7mm/80 mm) and the same stent without sirolimus coating in the right or left CA. Starting 3 days before the intervention aspirin was given for four weeks and clopidogrel was administered for 10 days. Angiography and IVUS were done after 6 weeks and 6 months.

After six weeks in both groups two subacute thrombotic occlusions were observed. In the remaining vessels the neointima was significantly reduced by sirolimus coated stents [SES] (5.9 ± 2.5 mm2 vs. 0.7 ± 1.0 mm2). Interestingly, the positive effect of SES sustained after 6 months whereas there was a significant increase of neointimal formation in the bare stents between 6 months and 6 weeks. Despite the sirolimus coating the inflammation around the stent struts was significantly higher in the SES.

Sirolimus self expanding nitinol stents may be an effective tool to reduce the restenosis rate in CA in selected cases. The high incidence of subacute thrombosis may be attributed to an insufficient antiplatelet therapy in a highly thrombotic setting with overstretch predilatation and long-stent implantation. Despite an inflammatory reaction around the stent struts of SES those stents had a persistent positive effect on the restenosis rate. The increased inflammation the SES might have been due to the coating of the drug eluting stents long after the complete release of sirolimus.

Tepe, G, Reddig, F, Laule, M, Muschick, P, Claussen, C, Duda, S, Sirolimus Eluting Stents in the Carotid Artery: Increased Inflammation But Persistent Prevention of Restenosis in Follow-up.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4411214.html