FRANCISCO RAFAEL MARTINS LAURINDO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/64, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/64, Hospital das Clínicas, Faculdade de Medicina - Líder
3 resultados
Resultados de Busca
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- Modelo porcino para avaliação e desenvolvimento de diferentes dispositivos coronários baseados em cateter: ferramenta pré-clínica fundamental(2013) GALON, Micheli Zanotti; TAKIMURA, Celso Kiyochi; CHAVES, Márcio J. Figueira; CAMPOS, Julliana Carvalho de; KRIEGER, J. Eduardo; GUTIERREZ, Paulo Sampaio; LAURINDO, Francisco Rafael Martins; KALIL FILHO, Roberto; LEMOS NETO, Pedro AlvesBACKGROUND: The experimental porcine model is anatomically and physiologically similar to the human heart, it is easily reproducible and very useful to test new stent and balloon generations. This study was aimed at analyzing an experimental model to evaluate different coronary devices for percutaneous coronary intervention. METHODS: We evaluated 131 juvenile commercial farm pigs, 109 were female, weighing 26.4 ± 3.2 kg. They were anesthetized and had mechanical ventilation and monitoring. Vascular access was obtained via the femoral artery by dissection or puncture. The coronary device was used after a selective catheterization of the coronary arteries with a JR 6 F catheter. Animals were maintained on mechanical ventilation until recovery and were submitted to angiographic evaluation 7, 28, 90 and/or 180 days after the procedure. After euthanasia, the hearts were collected and submitted to macro and microscopic analysis. RESULTS: Six drug-eluting stents, two drug-eluting balloons and two bare-metal stents were tested. Unplanned deaths were observed in 1.5% of the cases during the procedures and in 9.2% of the cases after the procedure, occurring within 12 hours to 6 days (2.3 ± 1.6 days). In addition to angiographic evaluations, intravascular ultrasound and optical coherence tomography were performed during the procedures in 20% and 60% of the cases, respectively. There was no deaths related to the use of the devices. CONCLUSIONS: The experimental percutaneous porcine model proved to be reproducible with similar outcomes and low mortality for the different devices tested and is an essential tool for the evaluation of new coronary devices.
- Evolução temporal da proliferação neointimal após implante de dois tipos de stent farmacológico com polímeros biodegradáveis em modelo porcino: avaliação qualitativa por tomografia de coerência óptica sequencial(2012) GALON, Micheli Zanotti; TAKIMURA, Celso Kiyochi; CARVALHO, Juliana; CHAVES, Márcio José Figueira; LACCHINI, Silvia; AIELLO, Vera Demarchi; GUTIERREZ, Paulo Sampaio; LAURINDO, Francisco Rafael Martins; LEMOS NETO, Pedro AlvesBACKGROUND: Based on the hypothesis that the neointima found in drug-eluting stents (DES) with biodegradable polymers at 28 days is not a definitive neointima and that optical coherence tomography (OCT) is an effective method for sequential neointimal evaluation, we aim, in this experimental study, to compare OCT findings at 28 and 90 days, in two different DES with biodegradable polymers: the sirolimus-eluting stent (Inspiron®, Scitech) and the biolimus A9-eluting stent (Biomatrix®, Biosensors International). METHODS: Overall, 6 non-atherosclerotic pigs were submitted to the implantation of 6 Inspiron® stents and 6 Biomatrix® stents. Each pig received both stent types, one in each coronary artery (left anterior descending artery and circumflex artery) and after 28 and 90 days qualitative in-stent OCT analyses were performed at 1-millimeter intervals. RESULTS: Qualitative assessment was performed in-stent pairing millimeter by millimeter. Heterogeneous neointimal tissue was evidenced in 39% at 28 days and in 0% at 90 days, the presence of intraluminal tissue in 18% at 28 days and in 0% at 90 days, luminal irregularity in 62% at 28 days and in 2% at 90 days (P < 0.005). There was no difference between groups regarding the quality of the neointima over time (P > 0.05). CONCLUSIONS: The OCT findings corroborate the hypothesis that the neointima found in DES with biodegradable polymers at 28 days is not a definitive neointima. The most significant experimental evidence is the change in the neointimal characteristics observed at sequential OCT.
- Estudo da dose excipiente: fármaco com avaliação da hiperplasia neointimal por tomografia de coerência óptica e histopatologia em artérias coronárias porcinas após o emprego do balão eluidor de sirolimus(2012) TAKIMURA, Celso Kiyochi; GALON, Micheli Zanotti; SOJITRA, Prakash; DOSHI, Manish; AIELLO, Vera; GUTIERREZ, Paulo Sampaio; CARVALHO, Juliana; FERREIRA, Suzane Kiss; CHAVES, Marcio Jose Figueira; LAURINDO, Francisco Rafael Martins; LEMOS, Pedro AlvesBACKGROUND: Magic TouchTM is a sirolimus based nano carrier balloon. We aimed at finding the excipient:drug ratio with the highest capacity to inhibit neointimal proliferation 28 days after the use of this balloon after bare metal stenting in porcine coronary arteries. METHODS: Fourteen domestic pigs with coronary bare metal stenting followed by dilation (60 seconds) using balloons with an excipient:sirolimus ratio of 1:1, 0.5:1, 0.25:1, 1:0 or a control balloon were evaluated. After 28 days neointimal hyperplasia was assessed by optical coherence tomography and histopathology. RESULTS: Percent neointimal hyperplasia (%) assessed by optical coherence tomography and histomorphometry was 32.2 and 35.1, 28.1 and 33.4, 17.3 and 20.9, 28.6 and 30.2, and 37.9 and 42.3 in the groups with 0.25:1, 0.5:1, 1:1, 1:0 excipient:sirolimus ratios and control balloon, respectively (P = 0.03 for excipient:sirolimus 1:1 versus control balloon). The neointimal interstrut thickness (mm) was 0.23, 0.30, 0.16, 0.24 and 0.30 in the groups with 0.25:1, 0.5:1, 1:1, 1:0 excipient:sirolimus ratios and control balloon, respectively (P < 0.01 for excipient:sirolimus 1:1 versus control balloon). The scores of inflammation, injury and fibrin deposition were low and there was no significant difference among groups. CONCLUSIONS: There was a stepwise increase in inhibitory efficacy of neointimal proliferation as the excipient concentration increased; the lowest efficacy was observed with the 0.25:1 excipient:sirolimus formulation and the most intensive inhibition was observed with the 1:1 excipient:sirolimus formulation. The 1:1 excipient:sirolimus formulation significantly reduced neointimal proliferation when compared to the control group, with low inflammation and injury scores.