(Circulation. 1995;92:1383-1386.)
© 1995 American Heart Association, Inc.
Articles |
Intracoronary Radiation Before Stent Implantation Inhibits Neointima Formation in Stented Porcine Coronary Arteries
From the Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine (R.W., K.A.R., S.J.P., G.D.C., S.B.K.), Department of Radiation Oncology (I.R.C.), and Department of Pathology (M.B.G.), Emory University School of Medicine, and the Health Physics Program, Georgia Institute of Technology (C.W.), Atlanta, Ga.
Correspondence to Spencer B. King III, MD, Andreas Gruentzig Cardiovascular Center, F606 Emory University Hospital, 1364 Clifton Rd NE, Atlanta, GA 30322.
Background Stent implantation has been shown to reduce restenosis by establishing a larger lumen but not by reducing neointima formation. We have previously shown that ionizing radiation reduced neointima formation after balloon injury in a swine model of restenosis. The purpose of this study was to determine whether endovascular irradiation of the coronary artery before stent implantation would affect neointima formation.
Methods and Results Nine normolipemic pigs underwent coronary angiography, and segments of the left anterior descending and left circumflex arteries were chosen as targets for stenting. A high-activity 192Ir source was used to deliver 14 Gy by random assignment to one of the vessels. After this, 3.5-mm tantalum stents were implanted in both arteries. Three additional pigs were treated with a 90Sr/Y source (a pure ß-emitter) delivering 14 Gy to five segments of coronary vessels that were stented immediately after irradiation. Stent-to-artery ratio was similar in the radiated and the control arteries. Animals received aspirin 325 mg daily and were killed at 28 days. The intimal area was significantly reduced in the irradiated stented arteries compared with control arteries treated with stent only (1.98 mm2 with 192Ir and 2.53 mm2 with 90Sr/Y versus 3.82 mm2 in the control stented arteries, P<.005).
Conclusions Endovascular radiation before coronary stenting reduces neointima formation and may further reduce the restenosis rate after stent implantation.
Key Words: stents • restenosis
This article has been cited by other articles:
 |
|
 |
|
  J. R Sindermann, V. Verin, J. W Hopewell, H. P. Rodemann, and J. H Hendry Biological aspects of radiation and drug-eluting stents for the prevention of restenosis Cardiovasc Res, July 1, 2004; 63(1): 22 - 30. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Bartels, A. Erasmi, F. Sayk, R. Eggers, A. Dendorfer, T. Feyerabend, W. Eichler, and Hans.-H. Sievers Prophylactic gamma radiation of unaffected vein grafts failed to prevent vein graft disease in a chronic hypercholesterolemic porcine model Eur. J. Cardiothorac. Surg., July 1, 2003; 24(1): 92 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C J McMahon, C E Mullins, and H G El Said Intrastent sonotherapy in pulmonary vein restenosis: a new treatment for a recalcitrant problem Heart, February 1, 2003; 89(2): e6 - 6. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P.W. Serruys, G. Sianos, W. van der Giessen, H.J.R.M. Bonnier, P. Urban, W. Wijns, E. Benit, M. Vandormael, R. Dorr, C. Disco, et al. Intracoronary {beta}-radiation to reduce restenosis after balloon angioplasty and stenting. The Beta Radiation In Europe (BRIE) study Eur. Heart J., September 1, 2002; 23(17): 1351 - 1359. [Abstract] [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. L. Kaluza, A. E. Raizner, W. Mazur, D. G. Schulz, J. M. Buergler, L. F. Fajardo, F. O. Tio, and N. M. Ali Long-Term Effects of Intracoronary {beta}-Radiation in Balloon- and Stent-Injured Porcine Coronary Arteries Circulation, April 24, 2001; 103(16): 2108 - 2113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Fitzgerald, A. Takagi, M. P. Moore, M. Hayase, F. D. Kolodgie, D. Corl, M. Nassi, R. Virmani, and P. G. Yock Intravascular Sonotherapy Decreases Neointimal Hyperplasia After Stent Implantation in Swine Circulation, April 10, 2001; 103(14): 1828 - 1831. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.Y Salame, S Verheye, I.R Crocker, N.A.F Chronos, K.A Robinson, and S.B King III Intracoronary radiation therapy Eur. Heart J., April 2, 2001; 22(8): 629 - 647. [PDF]
|
|
|
|
|
|
R. S. Kiesz, P. Buszman, J. L. Martin, E. Deutsch, M. M. Rozek, E. Gaszewska, M. Rewicki, P. Seweryniak, M. Kosmider, and M. Tendera Local Delivery of Enoxaparin to Decrease Restenosis After Stenting: Results of Initial Multicenter Trial : Polish-American Local Lovenox NIR Assessment Study (The POLONIA Study) Circulation, January 2, 2001; 103(1): 26 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Wohlfrom, J. Kotzerke, J. Kamenz, M. Eble, B. Hess, J. Wohrle, S. N Reske, V. Hombach, H. Hanke, and M. Hoher Endovascular irradiation with the liquid {beta}-emitter Rhenium-188 to reduce restenosis after experimental wall injury Cardiovasc Res, January 1, 2001; 49(1): 169 - 176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Makkar, J. Whiting, A. Li, H. Honda, M. C. Fishbein, F.F. Knapp, J. Hausleiter, F. Litvack, and N. L. Eigler Effects of {beta}--Emitting 188Re Balloon in Stented Porcine Coronary Arteries : An Angiographic, Intravascular Ultrasound, and Histomorphometric Study Circulation, December 19, 2000; 102(25): 3117 - 3123. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Hoffmann and G.S. Mintz Coronary in-stent restenosis--predictors, treatment and prevention Eur. Heart J., November 1, 2000; 21(21): 1739 - 1749. [PDF]
|
|
|
|
 |
|
 T. Takagi, K. Yoshida, T. Akasaka, S. Kaji, T. Kawamoto, Y. Honda, A. Yamamuro, T. Hozumi, and S. Morioka Hyperinsulinemia during oral glucose tolerance test is associated with increased neointimal tissue proliferation after coronary stent implantation in nondiabetic patients: A serial intravascular ultrasound study J. Am. Coll. Cardiol., September 1, 2000; 36(3): 731 - 738. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Raizner, S. N. Oesterle, R. Waksman, P. W. Serruys, A. Colombo, Y.-L. Lim, A. C. Yeung, W. J. van der Giessen, L. Vandertie, J. K. Chiu, et al. Inhibition of Restenosis With {beta}-Emitting Radiotherapy : Report of the Proliferation Reduction With Vascular Energy Trial (PREVENT) Circulation, August 29, 2000; 102(9): 951 - 958. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Waksman, R. L. White, R. C. Chan, B. G. Bass, L. Geirlach, G. S. Mintz, L. F. Satler, R. Mehran, P. W. Serruys, A. J. Lansky, et al. Intracoronary {gamma}-Radiation Therapy After Angioplasty Inhibits Recurrence in Patients With In-Stent Restenosis Circulation, May 9, 2000; 101(18): 2165 - 2171. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. S. Teirstein, V. Massullo, S. Jani, J. J. Popma, R. J. Russo, R. A. Schatz, E. M. Guarneri, S. Steuterman, K. Sirkin, D. A. Cloutier, et al. Three-Year Clinical and Angiographic Follow-Up After Intracoronary Radiation : Results of a Randomized Clinical Trial Circulation, February 1, 2000; 101(4): 360 - 365. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. P Lee, S. Lo, K. Forster, A. C Yeung, and S. N Oesterle Clinical applications of brachytherapy for the prevention of restenosis Vascular Medicine, November 1, 1999; 4(4): 257 - 268. [Abstract] [PDF]
|
|
|
|
|
|
A. J. Carter, D. Scott, L. Bailey, T. Hoopes, R. Jones, and R. Virmani Dose-Response Effects of 32P Radioactive Stents in an Atherosclerotic Porcine Coronary Model Circulation, October 5, 1999; 100(14): 1548 - 1554. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. O. Trerotola, T. J. Carmody, R. D. Timmerman, K. A. Bergan, R. G. Dreesen, S. V. Frost, and M. Forney Brachytherapy for the Prevention of Stenosis in a Canine Hemodialysis Graft Model: Preliminary Observations Radiology, September 1, 1999; 212(3): 748 - 754. [Abstract] [Full Text]
|
|
|
|
|
|
C. Hehrlein, S. Kaiser, R. Riessen, J.u. Metz, P. Fritz, and W. Kubler External beam radiation after stent implantation increases neointimal hyperplasia by augmenting smooth muscle cell proliferation and extracellular matrix accumulation J. Am. Coll. Cardiol., August 1, 1999; 34(2): 561 - 566. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Fareh, R. Martel, P. Kermani, and G. Leclerc Cellular Effects of ß-Particle Delivery on Vascular Smooth Muscle Cells and Endothelial Cells : A Dose-Response Study Circulation, March 23, 1999; 99(11): 1477 - 1484. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. S. Teirstein, V. Massullo, S. Jani, R. J. Russo, D. A. Cloutier, R. A. Schatz, E. M. Guarneri, S. Steuterman, K. Sirkin, S. Norman, et al. Two-Year Follow-Up After Catheter-Based Radiotherapy to Inhibit Coronary Restenosis Circulation, January 19, 1999; 99(2): 243 - 247. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Yonemitsu, Y. Kaneda, S. Tanaka, Y. Nakashima, K. Komori, K. Sugimachi, and K. Sueishi Transfer of Wild-Type p53 Gene Effectively Inhibits Vascular Smooth Muscle Cell Proliferation In Vitro and In Vivo Circ. Res., February 9, 1998; 82(2): 147 - 156. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Waksman, J. C. Rodriguez, K. A. Robinson, G. D. Cipolla, I. R. Crocker, N. A. Scott, S. B. King III, and J. N. Wilcox Effect of Intravascular Irradiation on Cell Proliferation, Apoptosis, and Vascular Remodeling After Balloon Overstretch Injury of Porcine Coronary Arteries Circulation, September 16, 1997; 96(6): 1944 - 1952. [Abstract] [Full Text]
|
|
|
|
|
|
D. Brieger and E. Topol Local drug delivery systems and prevention of restenosis Cardiovasc Res, September 1, 1997; 35(3): 405 - 413. [Full Text] [PDF]
|
|
|
|
 |
|
 P. S. Teirstein, V. Massullo, S. Jani, J. J. Popma, G. S. Mintz, R. J. Russo, R. A. Schatz, E. M. Guarneri, S. Steuterman, N. B. Morris, et al. Catheter-Based Radiotherapy to Inhibit Restenosis after Coronary Stenting N. Engl. J. Med., June 12, 1997; 336(24): 1697 - 1703. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. R. Holmes Preventing Coronary Restenosis and Complications N. Engl. J. Med., June 12, 1997; 336(24): 1747 - 1749. [Full Text]
|
|
|
|
|
|
M. Kearney, A. Pieczek, L. Haley, D. W. Losordo, V. Andres, R. Schainfeld, K. Rosenfield, and J. M. Isner Histopathology of In-Stent Restenosis in Patients With Peripheral Artery Disease Circulation, April 15, 1997; 95(8): 1998 - 2002. [Abstract] [Full Text]
|
|
|
|
|
|
E. Van Belle, F. O. Tio, T. Couffinhal, L. Maillard, J. Passeri, and J. M. Isner Stent Endothelialization: Time Course, Impact of Local Catheter Delivery, Feasibility of Recombinant Protein Administration, and Response to Cytokine Expedition Circulation, January 21, 1997; 95(2): 438 - 448. [Abstract] [Full Text]
|
|
|
|
|
|
W. J. van der Giessen and P. W. Serruys ß-Particle–Emitting Stents Radiate Enthusiasm in the Search for Effective Prevention of Restenosis Circulation, November 15, 1996; 94(10): 2358 - 2360. [Full Text]
|
|
|
|
|
|
A. J. Carter, J. R. Laird, L. R. Bailey, T. G. Hoopes, A. Farb, D. R. Fischell, R. E. Fischell, T. A. Fischell, and R. Virmani Effects of Endovascular Radiation From a ß-Particle–Emitting Stent in a Porcine Coronary Restenosis Model: A Dose-Response Study Circulation, November 15, 1996; 94(10): 2364 - 2368. [Abstract] [Full Text]
|
|
|
|
|
|
P. N. Ruygrok and P. W. Serruys Intracoronary Stenting: From Concept to Custom Circulation, September 1, 1996; 94(5): 882 - 890. [Full Text]
|
|
|
|
 |
|
 Radioactive Stents in Animal Models Journal Watch Cardiology, December 1, 1995; 1995(1201): 10 - 10. [Full Text]
|
|