Document Detail


Ionizing radiation to prevent arterial intimal hyperplasia at the edges of the stent: induces necrosis and fibrosis.
MedLine Citation:
PMID:  16716353     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although ionizing radiation has been proposed for the prevention of intimal hyperplasia in coronary and peripheral arteries in multicenter clinical trials, information is lacking on how irradiation affects arterial histology after stenting and especially how it affects the edges of the stent. We investigated intimal hyperplasia recasting with histological changes in arterial wall at the edges of the stent after arterial stenting followed by adequate external radiation for the prevention of intimal hyperplasia in pigs. MATERIALS AND METHODS: The aorta was experimentally stented in 30 pigs who were then assigned to two groups: irradiation with 20 Gy and a control group with no irradiation. The aorta was resected for morphometric and histological studies 6 weeks after procedure. RESULTS: Intimal thickness was reduced and the intima/media ratio was significantly lower in irradiated groups than in control pigs. In the irradiated group histological examination at the edges of the stent showed thin neointimal proliferation with an intact endothelium. In all sections analyzed in the 20-Gy irradiated group the vascular media at 45 days contained necrotic areas and fibrosis with calcifications. CONCLUSIONS: After arterial injury, adequate ionizing radiation effectively reduces neointimal thickening. Irradiation-induced histological changes include previously undetected recasting with necrosis and fibrosis at the arterial edges of the stent. The parietal recasting we observed in animal arteries irradiated at high doses is unclear and a cause of concern especially after clinical spontaneous dissection was recently reported. The use of ionizing radiation for the prevention of arterial restenosis awaits confirmation with a long-term follow-up including specific experimental histological analyses.
Authors:
Eric Ducasse; Jacques Chevalier; Jean-Marc Cosset; Colette Creusy; François Eschwege; Francesco Speziale; Enrico Sbarigia; Dominique Midy; Jean-Claude Baste; Eric Lartigau
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-05-22
Journal Detail:
Title:  The Journal of surgical research     Volume:  135     ISSN:  0022-4804     ISO Abbreviation:  J. Surg. Res.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-25     Completed Date:  2006-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  331-6     Citation Subset:  IM    
Affiliation:
Unit of Vascular Surgery, Tripode-Pellegrin Hospital, Bordeaux, France. eric.ducasse@chu-bordeaux.fr
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MeSH Terms
Descriptor/Qualifier:
Animals
Arteries / pathology*,  radiation effects*
Female
Hyperplasia / prevention & control,  radiotherapy
Immunohistochemistry
Radiation, Ionizing
Statistics, Nonparametric
Stents / adverse effects*
Sus scrofa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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