{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:21:44Z","timestamp":1773235304796,"version":"3.50.1"},"reference-count":51,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,3]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> No animal model currently exists for the examination of time-dependent histological changes occurring in intracranial vessels after endoluminal stent placement. The authors' goal was to develop a reproducible in vivo model of stent implantation in intracranial vessels in dogs that was capable of demonstrating stent-related vascular changes after the implantation of coated and uncoated devices.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> The authors implanted heparin-coated or uncoated stents in the basilar arteries (BAs) of 11 mongrel dogs. In a 12th animal, one coated stent was implanted in the BA and a second uncoated one was implanted in the distal anterior spinal artery. All the devices were oversized to induce intimal injury. Surviving animals were observed for 12 weeks, after which they underwent repeated angiography before planned death and removal of the brain. Histological studies and computer-assisted morphometric analyses were conducted on stent-treated and untreated sections of the BAs to assess the percentage of stenosis, neointimal proliferation, vessel injury, and inflammation. Perforating vessels partially covered by stent struts (\u201cjailing\u201d) were studied for evidence of stenosis or occlusion. The pathologist, interventionists, histopathologist, histopathology technicians, and radiologist were blinded to the stent type.<\/jats:p>\n<jats:p content-type=\"fine-print\">Seven stents (three uncoated and four coated) were removed from the six animals that were observed during the follow-up period. The mean neointimal proliferation was 0.42 mm<jats:sup>2<\/jats:sup> in the group treated with uncoated stents and 0.18 mm<jats:sup>2<\/jats:sup> in the group treated with heparin-coated devices (p = 0.04). Neointimal thickness was significantly increased in the group with uncoated stents (p = 0.04). The mean percentage of occlusion was less (12%) in the group with heparin-coated stents, compared with 22% in the group with uncoated devices (p = 0.07). When comparing results between the heparin-coated and uncoated devices implanted in the five animals that received a single stent only, greater differences (indicating a benefit from heparin-coated stents) were observed in neointimal area (p = 0.009), neointima\/media ratio (p = 0.001), neointimal thickness (p = 0.002), and percentage of occlusion (p = 0.009). All brainstem perforating vessels covered by stent struts remained patent.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> This in vivo intracranial stent model was developed to assess proliferative and inflammatory responses to endoluminal stent implantation in the cerebrovasculature. The results indicate that a lower percentage of occlusion occurs 12 weeks after implantation of heparin-coated compared with uncoated stents.<\/jats:p>","DOI":"10.3171\/jns.2003.98.3.0544","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:54:51Z","timestamp":1242237291000},"page":"544-553","source":"Crossref","is-referenced-by-count":26,"title":["In vivo model of intracranial stent implantation: a pilot study to examine the histological response of cerebral vessels after randomized implantation of heparin-coated and uncoated endoluminal stents in a blinded fashion"],"prefix":"10.3171","volume":"98","author":[{"given":"Elad I.","family":"Levy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan S.","family":"Boulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo A.","family":"Hanel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fermin O.","family":"Tio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald A.","family":"Alberico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Duffy","family":"Fronckowiak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balazs","family":"Nemes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann Marie","family":"Paciorek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee R.","family":"Guterman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Nelson","family":"Hopkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Catheter Cardiovasc Interv","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1002\/(SICI)1522-726X(199911)48:3<324::AID-CCD20>3.0.CO;2-K","article-title":"Preventive effects of the heparin-coated stent on restenosis in the porcine model.","volume":"48","author":"Ahn","year":"1999"},{"key":"b2","series-title":"AJNR","first-page":"1949","article-title":"Stenting of symptomatic stenosis of the intracranial internal carotid artery.","volume":"19","author":"Al-Mubarak","year":"1998"},{"key":"b3","series-title":"Heart and Stroke Facts: 1997 Statistical Supplement.","year":"1998"},{"key":"b4","series-title":"Int J Mol Med","first-page":"81","article-title":"Control of vascular smooth muscle cell growth and its implication in atherosclerosis and restenosis.","volume":"2","author":"Andres","year":"1998"},{"key":"b5","series-title":"Stroke","first-page":"1389","article-title":"Prognosis of patients with symptomatic vertebral or basilar artery stenosis. The Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study Group.","volume":"29","year":"1998"},{"key":"b6","series-title":"J Am Vet Med Assoc","first-page":"229","article-title":"1993 Report of the AVMA Panel on Euthanasia.","volume":"202","year":"1993"},{"key":"b7","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1001\/archneur.1985.04210090071021","article-title":"Vertebrobasilar insufficiency. A review.","volume":"42","author":"Ausman","year":"1985"},{"key":"b8","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1161\/01.CIR.96.2.636","article-title":"Paclitaxel inhibits arterial smooth muscle cell proliferation and migration in vitro and in vivo using local drug delivery.","volume":"96","author":"Axel","year":"1997"},{"key":"b9","series-title":"J Am Coll Cardiol","doi-asserted-by":"publisher","first-page":"1398","DOI":"10.1016\/0735-1097(94)90126-0","article-title":"Morphologic characteristics of lesion formation and time course of smooth muscle cell proliferation in a porcine proliferative restenosis model.","volume":"24","author":"Carter","year":"1994"},{"key":"b10","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/0140-6736(93)90139-8","article-title":"Abnormal growth regulation of vascular smooth muscle cells by heparin in patients with restenosis.","volume":"341","author":"Chan","year":"1993"},{"key":"b11","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1488","DOI":"10.1212\/WNL.45.8.1488","article-title":"The Warfarin-Aspirin Symptomatic Intracranial Disease Study.","volume":"45","author":"Chimowitz","year":"1995"},{"key":"b12","series-title":"Animal Welfare Act, Regulations, and Standards."},{"key":"b13","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1161\/01.CIR.95.6.1549","article-title":"Experimental study of thrombogenicity and foreign body reaction induced by heparin-coated coronary stents.","volume":"95","author":"De Scheerder","year":"1997"},{"key":"b14","series-title":"Neurosurgery","first-page":"436","article-title":"Reversal of focal misery perfusion after intracranial angioplasty: case report.","volume":"48","author":"Derdeyn","year":"2001"},{"key":"b15","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"2388","DOI":"10.1161\/circ.104.20.2388","article-title":"Intracoronary brachytherapy in the porcine model: a different animal.","volume":"104","author":"Fischell","year":"2001"},{"key":"b16","series-title":"Restenosis Following Arterial Reconstruction.","author":"Geary"},{"key":"b17","series-title":"J Vasc Surg","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/S0741-5214(98)70296-4","article-title":"Wound healing: a paradigm for lumen narrowing after arterial reconstruction.","volume":"27","author":"Geary","year":"1998"},{"key":"b18","series-title":"Arterioscler Thromb Vasc Biol","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1161\/01.ATV.16.1.34","article-title":"Time course of cellular proliferation, intimal hyperplasia, and remodeling following angioplasty in monkeys with established atherosclerosis. A nonhuman primate model of restenosis.","volume":"16","author":"Geary","year":"1996"},{"key":"b19","series-title":"AJNR","first-page":"971","article-title":"Elective stenting of symptomatic middle cerebral artery stenosis.","volume":"21","author":"Gomez","year":"2000"},{"key":"b20","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1161\/01.STR.31.1.95","article-title":"Elective stenting of symptomatic basilar artery stenosis.","volume":"31","author":"Gomez","year":"2000"},{"key":"b21","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1161\/01.CIR.93.3.423","article-title":"Reduction in thrombotic events with heparin-coated Palmaz-Schatz stents in normal porcine coronary arteries.","volume":"93","author":"Hardhammar","year":"1996"},{"key":"b22","series-title":"J Am Coll Cardiol","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.1016\/S0735-1097(00)00614-8","article-title":"Local paclitaxel delivery for the prevention of restenosis: biological effects and efficacy in vivo.","volume":"35","author":"Herdeg","year":"2000"},{"key":"b23","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"207","DOI":"10.3171\/jns.1989.70.2.0207","article-title":"Complications of intracranial bypass for vertebrobasilar insufficiency.","volume":"70","author":"Hopkins","year":"1989"},{"key":"b24","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1227\/00006123-198308000-00016","article-title":"Extracranial-intracranial arterial bypass and basilar artery ligation in the treatment of giant basilar artery aneurysms.","volume":"13","author":"Hopkins","year":"1983"},{"key":"b25","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"662","DOI":"10.3171\/jns.1987.66.5.0662","article-title":"Vertebrobasilar insufficiency. Part 2. Microsurgical treatment of intracranial vertebrobasilar disease.","volume":"66","author":"Hopkins","year":"1987"},{"key":"b26","series-title":"Coron Artery Dis","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1097\/00019501-199705000-00006","article-title":"A randomized animal study evaluating the efficacies of locally delivered heparin and urokinase for reducing in-stent restenosis.","volume":"8","author":"Kornowski","year":"1997"},{"key":"b27","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"1990","DOI":"10.1161\/01.CIR.87.6.1990","article-title":"Factors contributing to increased vascular fibrinolytic activity in mongrel dogs.","volume":"87","author":"Lang","year":"1993"},{"key":"b28","series-title":"Clinical Anatomy of Brain Stem Vessels.","author":"Lang","year":"1983"},{"key":"b29","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1097\/00006123-199909000-00025","article-title":"Factors affecting survival rates for acute vertebrobasilar artery occlusions treated with intraarterial thrombolytic therapy: a meta-analytical approach.","volume":"45","author":"Levy","year":"1999"},{"key":"b30","series-title":"Neurosurgery","first-page":"1215","article-title":"Transluminal stent-assisted angioplasty of the intracranial vertebrobasilar system for medically refractory, posterior circulation ischemia: early results.","volume":"48","author":"Levy","year":"2001"},{"key":"b31","series-title":"Ann Biomed Eng","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1007\/BF02684187","article-title":"Alteration of hemodynamics in aneurysm models by stenting: influence of stent porosity.","volume":"25","author":"Lieber","year":"1997"},{"key":"b32","series-title":"J Neurosurg","first-page":"169A","article-title":"Patency of arterial branches crossed by intracranial stents: fate of the \u201cjailed\u201d artery.","volume":"94","author":"Lopes","year":"2001"},{"key":"b33","series-title":"J Cardiovasc Pharmacol","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1097\/00005344-200204000-00007","article-title":"Reduction in neointimal formation with a stent coated with multiple layers of releasable heparin in porcine coronary arteries.","volume":"39","author":"Matsumoto","year":"2002"},{"key":"b34","series-title":"Am Heart J","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1016\/S0002-8703(98)70004-3","article-title":"The stent decade: 1987 to 1997. Stanford Stent Summit faculty.","volume":"136","author":"Oesterle","year":"1998"},{"key":"b35","series-title":"Clin Sci (Lond)","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1042\/cs0870467","article-title":"Smooth-muscle-cell proliferation and differentiation in neointima formation and vascular restenosis.","volume":"87","author":"Pauletto","year":"1994"},{"key":"b36","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1344","DOI":"10.1097\/00006123-200006000-00012","article-title":"Prevention and treatment of thromboembolic and ischemic complications associated with endovascular procedures: Part I\u2014Pathophysiological and pharmacological features.","volume":"46","author":"Qureshi","year":"2000"},{"key":"b37","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"771","DOI":"10.3171\/jns.2000.92.5.0771","article-title":"Stent-assisted angioplasty of intracranial vertebrobasilar atherosclerosis: an initial experience.","volume":"92","author":"Rasmussen","year":"2000"},{"key":"b38","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1161\/01.CIR.93.6.1141","article-title":"Distribution of hyaluronan during extracellular matrix remodeling in human restenotic arteries and balloon-injured rat carotid arteries.","volume":"93","author":"Riessen","year":"1996"},{"key":"b39","series-title":"Proc Natl Acad Sci USA","doi-asserted-by":"publisher","first-page":"10134","DOI":"10.1073\/pnas.95.17.10134","article-title":"A mAb to the beta2-leukocyte integrin Mac-1 (CD11b\/CD18) reduces intimal thickening after angioplasty or stent implantation in rabbits.","volume":"95","author":"Rogers","year":"1998"},{"key":"b40","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1161\/01.CIR.88.3.1215","article-title":"Inhibition of experimental neointimal hyperplasia and thrombosis depends on the type of vascular injury and the site of drug administration.","volume":"88","author":"Rogers","year":"1993"},{"key":"b41","series-title":"Circ Res","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1161\/01.RES.77.3.445","article-title":"The intima. Soil for atherosclerosis and restenosis.","volume":"77","author":"Schwartz","year":"1995"},{"key":"b42","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1161\/01.CIR.103.2.192","article-title":"Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries: a quantitative coronary angiography and three-dimensional intravascular ultrasound study.","volume":"103","author":"Sousa","year":"2001"},{"key":"b43","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"2007","DOI":"10.1161\/hc4201.098056","article-title":"Sustained suppression of neointimal proliferation by sirolimus-eluting stents: one-year angiographic and intravascular ultrasound follow-up.","volume":"104","author":"Sousa","year":"2001"},{"key":"b44","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1161\/hc3601.093987","article-title":"Stent-based delivery of sirolimus reduces neointimal formation in a porcine coronary model.","volume":"104","author":"Suzuki","year":"2001"},{"key":"b45","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"2366","DOI":"10.1161\/01.CIR.100.23.2366","article-title":"Long-term coronary vascular response to (32)P beta-particle-emitting stents in a canine model.","volume":"100","author":"Taylor","year":"1999"},{"key":"b46","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1212\/WNL.55.4.490","article-title":"Symptomatic intracranial atherosclerosis: outcome of patients who fail antithrombotic therapy.","volume":"55","author":"Thijs","year":"2000"},{"key":"b47","series-title":"Am J Cardiol","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/S0002-9149(00)00951-6","article-title":"Heparin-coated Wiktor stents in human coronary arteries (MENTOR trial). MENTOR Trial Investigators.","volume":"86","author":"Vrolix","year":"2000"},{"key":"b48","series-title":"Clin Exp Pharmacol Physiol","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1046\/j.1440-1681.2001.03543.x","article-title":"Inflammation as a key event in the development of neointima following vascular balloon injury.","volume":"28","author":"Wainwright","year":"2001"},{"key":"b49","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1097\/00006123-199808000-00126","article-title":"Stents for intracranial aneurysms: the beginning of a new endovascular era?","volume":"43","author":"Wakhloo","year":"1998"},{"key":"b50","series-title":"AJNR","first-page":"1043","article-title":"Self-expanding nitinol stents in canine vertebral arteries: hemodynamics and tissue response.","volume":"16","author":"Wakhloo","year":"1995"},{"key":"b51","series-title":"Circulation","doi-asserted-by":"publisher","first-page":"3121","DOI":"10.1161\/hc5001.100837","article-title":"Oral heparin prevents neointimal hyperplasia after arterial injury: inhibitory potential depends on type of vascular injury.","volume":"104","author":"Welt","year":"2001"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/98\/3\/article-p544.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/98\/3\/article-p544.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/98\/3\/article-p544.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T19:58:39Z","timestamp":1679860719000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/98\/3\/article-p544.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,3]]},"references-count":51,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns.2003.98.3.0544","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2003,3]]}}}