(Circulation. 1999;100:2366.)
© 1999 American Heart Association, Inc.
Basic Science Reports |
Long-Term Coronary Vascular Response to 32P ß-Particle–Emitting Stents in a Canine Model
Presented at the 71st Scientific Sessions of the American Heart Association, Dallas, Tex, November 11, 1998.
From the Division of Hematology and Vascular Biology, Walter Reed Army Institute of Research and the Cardiovascular Division, Armed Forces Institute of Pathology, Washington, DC.
Correspondence to Renu Virmani, MD, Chairperson, Cardiovascular Division, Armed Forces Institute of Pathology, 14th Street and Alaska Avenue, NW, Washington, DC 20306. E-mail virmani{at}afip.osd.mil
Background—The arterial placement of 32P ß-particle–emitting stents in various experimental animal models results in discordant effects on neointimal formation. We studied the vascular effects of ß-particle–emitting stents in normal canine coronary arteries because compared with pigs and rabbits, the canine model may more closely mimic the vascular response of humans.
Methods and Results—Thirty stents (control nonradioactive, n=10; low-activity 32P, 3.5 to 6.0 µCi, n=11; high-activity 32P, 6.5 to 14.4 µCi, n=8) were implanted in normal canine coronary arteries through the use of a single balloon inflation at nominal pressure. Histological analysis after 15 weeks included the measurement of neointimal and adventitial area and thickness. Neointimal fibrin area was measured with the use of computer-assisted color segmentation on Movat pentachrome sections. Luminal stenosis was significantly increased in 32P stents compared with control stents (44.6±16.8% versus 32.7±10.8%; P=0.05) and was highest in the high-activity group (45.5±24.3%). No evidence of an "edge effect" was seen in adjacent, nonstented coronary segments. All 32P stents showed incomplete vascular healing as indicated by a dose-dependent increase in fibrin area with increasing stent activity. Arterial radiation resulted in a decrease in adventitial size, which was maximal for high-activity 32P stents, indicating an inhibitory effect on the adventitial response to injury.
Conclusions—32P ß-particle–emitting stents have adverse vascular effects at 15 weeks in the canine normal coronary artery model. Vascular brachytherapy with this device causes increased neointimal formation and prominent, dose-dependent lack of healing.
Key Words: stents • radiotherapy • radioisotopes • restenosis • revascularization
This article has been cited by other articles:
 |
|
 |
|
  J. M. A. Meyer, B. Nowak, K. Schuermann, A. Buecker, F. Moltzahn, A. Kulisch, N. Heussen, T. Gorgen, U. Bull, and R. W. Gunther Inhibition of Neointimal Proliferation with 188Re-labeled Self-Expanding Nitinol Stent in a Sheep Model Radiology, December 1, 2003; 229(3): 847 - 854. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Raymond, P. Leblanc, F. Morel, I. Salazkin, G. Gevry, and S. Roorda Beta Radiation and Inhibition of Recanalization After Coil Embolization of Canine Arteries and Experimental Aneurysms: How Should Radiation Be Delivered? Stroke, May 1, 2003; 34(5): 1262 - 1268. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kozuma, M.A. Costa, W.J. van der Giessen, M. Sabate, J.M.R. Ligthart, V.L.M.A. Coen, I.P. Kay, A.J. Wardeh, A.H.M. Knook, P.J de Feyter, et al. Initial observation regarding changes in vessel dimensions after balloon angioplasty and stenting followed by catheter-based {beta}-radiation. Is stenting necessary in the setting of catheter-based radiotherapy? Eur. Heart J., April 2, 2002; 23(8): 641 - 649. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Raymond, P. Leblanc, A.-C. Desfaits, I. Salazkin, F. Morel, C. Janicki, and S. Roorda In Situ Beta Radiation to Prevent Recanalization After Coil Embolization of Cerebral Aneurysms Stroke, February 1, 2002; 33(2): 421 - 427. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Fischell and R. Virmani Intracoronary Brachytherapy in the Porcine Model: A Different Animal Circulation, November 13, 2001; 104(20): 2388 - 2390. [Full Text] [PDF]
|
|
|
|
|
|
P. K. Coussement, H. de Leon, T. Ueno, M. Y. Salame, S. B. King III, N. A.F. Chronos, and K. A. Robinson Intracoronary {beta}-Radiation Exacerbates Long-Term Neointima Formation in Balloon-Injured Pig Coronary Arteries Circulation, November 13, 2001; 104(20): 2459 - 2464. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Tepe, L. M. Dinkelborg, U. Brehme, P. Muschick, B. Noll, T. Dietrich, A. Greschniok, A. Baumbach, C. D. Claussen, and S. H. Duda Prophylaxis of Restenosis With 186Re-Labeled Stents in a Rabbit Model Circulation, August 6, 2001; 104(4): 480 - 485. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. W. Heldman, L. Cheng, G. M. Jenkins, P. F. Heller, D.-W. Kim, M. Ware Jr, C. Nater, R. H. Hruban, B. Rezai, B. S. Abella, et al. Paclitaxel Stent Coating Inhibits Neointimal Hyperplasia at 4 Weeks in a Porcine Model of Coronary Restenosis Circulation, May 8, 2001; 103(18): 2289 - 2295. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Farb, S. Shroff, M. John, W. Sweet, and R. Virmani Late Arterial Responses (6 and 12 Months) After 32P {beta}-Emitting Stent Placement : Sustained Intimal Suppression With Incomplete Healing Circulation, April 10, 2001; 103(14): 1912 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.J Wardeh, A.H.M Knook, I.P Kay, M Sabate, V.L.M.A Coen, D.P Foley, J.N Hamburger, P.C Levendag, W.J van der Giessen, and P.W Serruys Clinical and angiographical follow-up after implantation of a 6-12{micro}Ci radioactive stent in patients with coronary artery disease Eur. Heart J., April 2, 2001; 22(8): 669 - 675. [Abstract] [PDF]
|
|
|
|
 |
|
 F. D. Kolodgie, A. Farb, and R. Virmani Local Delivery of Ceramide for Restenosis : Is There a Future for Lipid Therapy? Circ. Res., August 18, 2000; 87(4): 264 - 267. [Full Text] [PDF]
|
|