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(Circulation. 2002;105:550.)
© 2002 American Heart Association, Inc.

Brief Rapid Communications

Angiographical Follow-Up After Radioactive "Cold Ends" Stent Implantation

A Multicenter Trial

A.J. Wardeh, MD, PhD; R. Albiero, MD; I.P. Kay, MBChB, PhD; A.H.M. Knook, MD; W. Wijns, MD, PhD; K. Kozuma, MD, PhD; T. Nishida, MD; V. Ferrero, MD; P.C. Levendag, MD, PhD; W.J. van der Giessen, MD, PhD; A. Colombo, MD; P.W. Serruys, MD, PhD

From Thoraxcenter Rotterdam (A.J.W., I.P.K., A.H.M.K., K.K., W.J.V.D.G., P.W.S.) and the Daniel den Hoed Cancer Center (P.C.L.), University Hospital Rotterdam, Rotterdam, The Netherlands; EMO Centro Cuore Columbus (R.A., T.N., A.C.), Milan, Italy; and Onze Lieve Vrouwe Ziekenhuis (W.W., V.F.), Aalst, Belgium.

Correspondence to Prof Patrick W. Serruys, MD, PhD, Dept of Interventional Cardiology, Thoraxcenter Bd 406, University Hospital Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. E-mail Serruys{at}card.azr.nl

Background— Radioactive stents with an activity of 0.75 to 12 µCi have shown >40% edge restenosis due to neointimal hyperplasia and negative remodeling. This trial evaluated whether radioactive Cold Ends stents might resolve edge restenosis by preventing remodeling at the injured extremities.

Methods and Results— The 25-mm long (15-mm radioactive center and 5-mm nonradioactive ends) Cold Ends stents had an activity of 3 to 12 µCi at implantation. Forty-three stents were implanted in 43 patients with de novo native coronary artery disease. Two procedural, 1 subacute, and 1 late stent thrombosis occurred. A restenosis rate of 22% was observed with a shift of the restenosis, usually occurring at the stent edges of radioactive stents, into the Cold Ends stents. The most severe restenosis occurred at the transition zone from radioactive to nonradioactive segments, a region located in dose fall-off.

Conclusion— Cold Ends stents did not resolve edge restenosis.

Key Words: radioisotopes • restenosis • stents

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