Document Detail


Intracoronary radiation decreases the second phase of intimal hyperplasia in a repeat balloon angioplasty model of restenosis.
MedLine Citation:
PMID:  9308953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Repeat balloon angioplasty is likely to induce intimal proliferation, which is associated with a higher restenosis rate. This study examined the effect of intracoronary ionizing radiation on restenotic lesions using repeat balloon injury in a normolipemic swine. METHODS AND MATERIALS: Eight domestic normolipemic pigs underwent overstretch balloon angioplasty with a 3.5 mm balloon in the LAD and LCX, followed by repeat balloon injury at the same sites 4 weeks after the initial injury. At that time a high activity 192Iridium source was introduced immediately after the angioplasty by random assignment to deliver 14 Gy at 2 mm in eight of the injured coronary arteries (LAD and LCX). One month later the animals were killed and the coronary arteries pressure perfusion fixed. Serial sections were stained with H&E and VVG, then evaluated by histopathologic and morphometric techniques. Maximal intimal thickness (MIT), intimal area (IA), and intimal area corrected for the extent of injury (IA/FL) were measured in the irradiated and control arteries and were compared to control arteries with single injuries from previous studies. RESULTS: Repeat balloon injury induced significant additional medial damage, which was associated with marked intimal hyperplasia in a concentric pattern. Intracoronary irradiation significantly decreased the total of neointima area formation (IA 93 + 0.35 mm2 compared to control 1.38 + 0.33 mm2 p < 0.01) and the MIT was also significantly reduced in the irradiated vessels (0.57 + 0.18 mm vs. 0.71 + 0.08 mm, p = 0.05). CONCLUSIONS: Intracoronary irradiation immediately after the second balloon dilatation inhibits the intimal hyperplasia due to that injury. However, there was no effect on the existing neointima from the initial injury.
Authors:
R Waksman; K A Robinson; I R Crocker; M B Gravanis; G D Cipolla; K B Seung; S B King
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  39     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-10-16     Completed Date:  1997-10-16     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  475-80     Citation Subset:  IM    
Affiliation:
Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon / adverse effects*
Animals
Coronary Disease / radiotherapy*
Disease Models, Animal
Female
Hyperplasia / radiotherapy
Recurrence
Swine
Tunica Intima / pathology*,  radiation effects

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