The Effects of Paclitaxel-Eluting Stents on Development of In-Stent Restenosis in the Iliac Vein after Thrombus Removal in a Goat Model.

Abstract

Purpose: To assess whether paclitaxel-drug eluting stent (Paclitaxel-DES) can inhibit in-stent restenosis (ISR) in the iliac vein after thrombectomy.

Materials and methods: A bilateral iliac vein thrombosis model was established in 12 goats. Three days after thrombosis induction, percutaneous mechanical thrombectomy (PMT) was performed for bilateral iliac vein thrombosis. A Paclitaxel-DES was placed in one iliac vein, while a bare-metal stent (BMS) was placed in the contralateral vein as a control. ISR and intimal hyperplasia were evaluated using angiography, optical coherence tomography, and histopathological examination at 1, 2, and 6 months after stent implantation.

Results: Compared to the BMS group, the Paclitaxel-DES group showed significantly reduced intimal hyperplasia at 1 and 2 months postoperatively and exhibited a lower percent area stenosis (P < 0.01). Fluorescence staining revealed lower smooth muscle cell expression and higher inflammation scores in the Paclitaxel-DES group at 1 month (P < 0.05). However, no significant differences in the percent area stenosis or lumen loss rate were observed between the two groups at 6 months post-implantation (P > 0.05).

Conclusion: Paclitaxel-DES significantly inhibited intimal hyperplasia and reduced ISR during the early stages after iliac vein thrombectomy. No significant difference in lumen loss was observed between the Paclitaxel-DES and BMS groups after 6 months, suggesting a potential late catch-up effect in the Paclitaxel-DES group.