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(Circulation. 2000;101:2454.)
© 2000 American Heart Association, Inc.
Brief Rapid Communications |
Edge Restenosis After Implantation of High Activity 32P Radioactive ß-Emitting Stents
From Emodinamica Centro Cuore Columbus, Milan, Italy.
Correspondence to Remo Albiero, MD, EMO Centro Cuore Columbus, Via M. Buonarroti 48, 20145 Milan, Italy. E-mail albire{at}micronet.it
Background—A high restenosis rate has been reported at the edges ("edge restenosis") of 32P radioactive stents with an initial activity level of 3 to 12 µCi. This edge effect might be due to balloon injury and to a low dose of radiation at the stent margins. The aim of this study was to evaluate whether the implantation of 32P radioactive stents with a higher activity level (12 to 21 µCi) combined with a nonaggressive stent implantation strategy could solve the problem of edge restenosis.
Methods and Results—We compared the results of lesions treated with single radioactive BX stents with an activity of 12 to 21 µCi (group 2, n=54 lesions) with the results of lesions treated by single radioactive BX stents with an initial activity level of 3 to 12 µCi (group 1, n=42 lesions). There were no procedural events. At the 6-month follow-up, no myocardial infarctions, deaths, or stent thromboses had occurred. Intrastent binary restenosis was 0% in group 1 versus 4% in group 2 (n=2, both at the ostium of the right coronary artery, P=NS). Intrastent neointimal hyperplasia was significantly lower in group 2 than in group 1. The intralesion (intrastent plus peri-stent) restenosis rate was 38% in group 1 versus 30% in group 2 (P=NS).
Conclusions—Single 32P radioactive stents with an initial activity level of 12 to 21 µCi reduced intrastent neointimal hyperplasia compared with stents of 3 to 12 µCi, but they did not solve the problem of edge restenosis, even if a nonaggressive stent implantation strategy was used.
Key Words: radioisotopes • stents • restenosis • coronary disease
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