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 was performed for bilateral iliac vein thrombosis. A Paclitaxel-DES was placed in 1 iliac vein, whereas 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 with 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 < .01). Fluorescence staining revealed lower smooth muscle cell expression and higher inflammation scores in the Paclitaxel-DES group at 1 month (P < .05). However, no significant differences in the percent area stenosis or lumen loss rate were observed between the 2 groups at 6 months after implantation (P > .05). CONCLUSIONS: 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.