Vulnerable carotid atherosclerotic plaque creation in a Swine model: evaluation of stenosis creation using absorbable and permanent suture in a diabetic dyslipidemic model.

PURPOSE: To compare the creation of carotid atherosclerotic plaque after stenosis creation with absorbable or permanent suture in a diabetic dyslipidemic swine model.

MATERIALS AND METHODS: A high-cholesterol diet was fed to 15 Sinclair pigs. Diabetes was induced by intraarterial injection of streptozotocin. Stenosis creation in carotid arteries was performed with an absorbable or a permanent suture assigned randomly on both sides. After 20 weeks, Doppler ultrasound (US), angiography, and intravascular US examinations were performed before sacrifice. Carotid, coronary, and femoral arteries were analyzed by histology according to the American Heart Association (AHA) classification.

RESULTS: Three animals died during the perioperative period, and three others died during follow-up. Diabetes was successfully induced in all surviving animals (9 of 15). On angiography, stenoses were estimated at 80.4%±12.4 in carotid arteries with permanent sutures and at 48.8%±39 with absorbable sutures (P = .03). With permanent suturing, carotid plaques were observed in all animals with five of nine manifesting an AHA stage IV or more. With absorbable suture, atherosclerosis developed in seven of nine carotid arteries including three animals with an AHA stage IV or more. Advanced coronary and femoral plaques were observed in four and one of the nine animals. A correlation between AHA classes of coronary plaques and cholesterol level was observed (P = .01), whereas for carotid arteries, AHA class correlated with the degree of stenosis (P = .045).

CONCLUSIONS: Creation of atheromatous lesions in carotid and coronary arteries was successful with this model despite a high mortality rate. Less severe carotid stenoses and advanced plaques were observed with absorbable sutures.