improved patency of transjugular intrahepatic portosystemic shunt: the efficacy of cilostazol for the prevention of pseudointimal hyperplasia in swine TIPS models

Cardiovasc Intervent Radiol. 2007 Jul-Aug;30(4):719-24. doi: 10.1007/s00270-007-9001-1.

Abstract

Purpose: To investigate the efficacy of oral administration of cilostazol to inhibit pseudointimal/intimal hyperplasia in swine TIPS models.

Methods: Successful TIPS creation was carried out in 11 of 12 healthy young pigs (20-25 kg). In the treatment group (n = 6), both cilostazol and aspirin were administered daily, from the first day of TIPS creation. The control group (n = 5) was administered only aspirin. The animals were followed-up for 2 weeks and then killed. The specimen (including portal vein, hepatic parenchymal tract, hepatic vein, and inferior vena cava) and stents were carefully bisected in a longitudinal fashion. The control group was compared with the treatment group by means of a gross and histologic evaluation of the degree of pseudointimal/intimal hyperplasia in the shunt.

Results: At the gross evaluation, the control group showed considerably more pseudointimal/intimal hyperplasia than the treatment group. Using microscopic evaluation, there was a statistically significant difference (p < 0.05) in the mean maximum pseudointimal/intimal hyperplasia thickness between the control group (2.97 +/- 0.33 mm) and treatment group (0.73 +/- 0.27 mm).

Conclusion: Oral administration of cilostazol may have been effective in reducing pseudointimal/intimal hyperplasia in swine TIPS models.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Animals
  • Aspirin / pharmacology
  • Cilostazol
  • Disease Models, Animal*
  • Fibrinolytic Agents / pharmacology*
  • Fibromuscular Dysplasia / prevention & control*
  • Hepatic Veins / drug effects
  • Hepatic Veins / pathology
  • Portal Vein / drug effects
  • Portal Vein / pathology
  • Portasystemic Shunt, Transjugular Intrahepatic / methods*
  • Swine
  • Tetrazoles / pharmacology*
  • Vena Cava, Inferior / drug effects
  • Vena Cava, Inferior / pathology

Substances

  • Fibrinolytic Agents
  • Tetrazoles
  • Cilostazol
  • Aspirin