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Balloon-Expandable Biodegradable Stents Versus Self-Expandable Metallic Stents: A Comparison Study of Stent-Induced Tissue Hyperplasia in the Rat Urethra

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Abstract

Purpose

To compare the degrees of stent-induced tissue hyperplasia of balloon-expandable, biodegradable stents (BEBSs) with those of self-expandable metallic stents (SEMSs) in a rat urethral model.

Materials and Methods

A total of 20 rats were randomized into two groups. The BEBS group (n = 10) received a poly-l-lactic acid (PLLA) biodegradable stent. The SEMS group (n = 10) received a nitinol bare stent. All rats were killed eight weeks after stent placement. The degree of stent-induced tissue hyperplasia was assessed by comparing the results of retrograde urethrography and histologic examination between the two groups.

Results

Stent placement was technically successful in all rats. Two rats in the BEBS group were excluded due to procedure-related death. The mean luminal diameter of stented urethra on urethrograms was not significantly different at 4 and 8 weeks between the two groups. On histologic analysis, the percentage of granulation tissue area (p < 0.001) and the thickness of papillary projection (p < 0.001) were significantly higher in the BEBS group compared with the SEMS group. The inflammatory cell infiltration showed a clear tendency to significance (p = 0.050). There were no statistical differences in the number of epithelial layers and the thickness of submucosal fibrosis between the two groups.

Conclusion

Formation of stent-induced tissue hyperplasia was significantly evident in the rat urethra with similar degrees between the BEBS and the SEMS. The BEBS was associated with a thicker papillary projection and larger granulation tissue area resulting from higher inflammation compared with the SEMS.

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Funding

This study was supported by Fund of Biomedical Research Institute (CUH2018-0022), Chonbuk National University Hospital

Author information

Author notes

  1. Jung-Hoon Park and Tae-Hyung Kim equally contributed to this work as the first authors.

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Jung-Hoon Park, Young Chul Cho & Nader Bakheet

  2. Department of Biomedical Engineering Research Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Jung-Hoon Park

  3. Department of Radiological Science, Kangwon National University, 346 Hwangjo-gil, Dogye-eup, Samcheok-Si, Kangwon-do, 25949, Republic of Korea

    Tae-Hyung Kim

  4. Division of Gastroenterology, Department of Internal Medicine, and Research Institute of Clinical Medicine, Chonbuk National University, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea

    Seung Ok Lee & Seong-Hun Kim

  5. Department of Radiology, and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea

    Kun Yung Kim

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Park, JH., Kim, TH., Cho, Y.C. et al. Balloon-Expandable Biodegradable Stents Versus Self-Expandable Metallic Stents: A Comparison Study of Stent-Induced Tissue Hyperplasia in the Rat Urethra. Cardiovasc Intervent Radiol 42, 1343–1351 (2019). https://doi.org/10.1007/s00270-019-02239-0

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  • DOI: https://doi.org/10.1007/s00270-019-02239-0

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