Key result
Subclavian stenting causes ~14-point higher area stenosis and greater peri-strut fibrin than carotid stenting.
Why the study?
Swine carotid and subclavian arteries are commonly used in preclinical vascular device studies, but regional differences in peri-strut healing responses between these vascular territories remained incompletely defined.
Does self-expanding stent implantation in the subclavian artery result in different histopathological vascular healing and neointimal formation compared with the carotid artery in domestic swine?
Does self-expanding stent implantation in the subclavian artery result in different histopathological vascular healing and neointimal formation compared with the carotid artery in domestic swine?
Preclinical stent evaluation in swine demonstrates that subclavian arteries exhibit delayed peri-strut healing and greater neointimal stenosis at 28 days compared with carotid arteries, highlighting the importance of anatomical territory selection in vascular device testing.
Answers are grounded in this paper and cite their sources.
May indicate artery-specific stent responses in swine models; leaves open translation to human vascular interventions.
Purpose Vascular healing after stent implantation is influenced by local biomechanical and anatomical environments. Swine carotid and subclavian arteries are commonly used in preclinical vascular device studies; however, regional differences in peri-strut healing responses between these vascular territories remain incompletely defined. This study compared histopathological vascular healing after stent implantation in swine carotid and subclavian arteries. Materials and methods Self-expanding stents were implanted in both carotid and subclavian arteries in the same domestic swine according to the instructions for use. Animals survived for either 3 or 28 days before necropsy (n=6/time point). Stented vessels were perfusion-fixed, embedded in plastic, and stained with hematoxylin and eosin and Movat's pentachrome stain. Histopathological evaluation included injury, inflammation, fibrin, thrombus, endothelialization, neointimal maturity, fibrosis, and hemorrhage. Histomorphometry included percent stenosis, neointimal thickness, and area. Results Stent-to-artery ratios were comparable between carotid and subclavian arteries. At 28 days, subclavian arteries demonstrated significantly greater persistent peri-strut fibrin deposition and intramural hemorrhage than carotid arteries (fibrin: 1.67 ± 0.72 vs. 0.03 ± 0.18, p<0.05; hemorrhage: 1.53 ± 1.06 vs. 0.03 ± 0.18, p<0.05). Percent area stenosis was also greater in subclavian arteries (28.77 ± 18.35% vs. 14.94 ± 5.25%, p<0.05). No significant regional differences were observed at 3 days. Conclusion Subclavian arteries demonstrated peri-strut delayed vascular healing characterized by persistent fibrin deposition, hemorrhage, and increased neointimal formation compared with carotid arteries despite similar stent deployment conditions. Mechanical stress associated with forelimb movement may contribute to delayed healing and subsequent neointimal formation in the subclavian artery.
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Isobe et al. (2026) studied Vascular healing after stent implantation (n=12). Self-expanding stent implantation in subclavian artery vs. Self-expanding stent implantation in carotid artery (within the same animal) was evaluated on Histopathological evaluation (peri-strut fibrin deposition, intramural hemorrhage) and histomorphometric percent area stenosis at 28 days (p=<0.05). Subclavian artery stenting showed greater 28-day percent area stenosis (28.77% vs 14.94%, p<0.05) and peri-strut fibrin (1.67 vs 0.03, p<0.05) than carotid stenting in swine.
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