Construction Of Artery Injury Model And Transplantation Of Endothelial Progenitor Cells To Prevent Restenosis After Percutaneous Transluminal Angioplasty

Objective To investigate the feasibility of establishing of the rabbit carotid artery balloon injury model and transplanting of endothelial progenitor cells (EPCs) to the injury region by the Fogarty balloon to prevent restenosis after percutaneous transluminal angioplasty.Methods EPCs were isolated from rabbit peripheral blood and were labeled with Fe2O3-arginine. Rabbits were randomly divided into cell group (n=12) and blank group (n=14). The Fogarty balloon catheter was induced into the right common carotid artery (CCA) through the right femoral artery, and then blocking blood flow to transplant EPCs and equal amount of normal saline to the balloon injury local via Fogarty balloon in the cell and blank group respectively. MRI was performed on 3rd day,1st,4th and 8th week after injury, respectively. The injured vessel was harvested from one rabbit randomly selected in blank group for HE staining immediately after injury and on 3rd day, 1 st,4th and 8th week after injury. On 1 st week after injury, the injured vessels of two rabbits randomly selected in cell group were harvested for Prussian blue staining. All the remaining rabbits in two groups were sacrificed on 8th week, and the injured vessels were harvested for HE, elastic tissue and PCNA staining after injury, respectively.Results Both MRI and HE staining of blank group rabbits showed detachment of injured endothelial cells immediately after injury. The injured vessel wall became thickened with edema and inflammatory cell infiltration, and the vessel lumen was still dilated on 3rd day. The repair and slight hyperplasia of the injured intima can be seen on 1st week. Hyperplasia of the intima became more obvious on 4th week after injury. The intima with severe hyperplasia and a very narrowed vessel lumen can be seen on 8th week. Prussian blue staining showed iron-labeled cells distributed in the injured intima in cell group. MRI showed that the injured arterial wall in blank group rabbits was thicker than that of the rabbits in cell group on 4th,8th week and stenotic degree of the lumen in blank group rabbits were more serious. The histopathological study showed the neointima/media ratio (N/M) in blank group and cell group was 1.14±0.10 and 0.34±0.05, respectively (P<0.01), and the index of PCNA positive cell in blank group and cell group was 0.31±0.01 and 0.08±0.01, respectively (P<0.05) on 8th week after injury.Conclusion The Fogarty balloon can be used to establish rabbit carotid artery balloon injury model, and local transplantation of EPCs through Fogarty balloon to the injury region may prevent restenosis after percutaneous transluminal angioplasty.