Abstract
Background: Neointimal formation causes restenosis after intracoronary stent placement. Endovascular radiation delivered via a stent has been shown to reduce neointimal formation after placement in porcine and rabbit iliac arteries. THe objective of this study was to evaluate the dose-related effects of a β-particle-emitting radioactive stent in a porcine coronary restenosis model. Methods and Results: Thirty-seven swine underwent placement of 35 nonradioactive and 39 β-particle-emitting stents with activity levels of 23.0, 14.0, 6.0, 3.0, 1.0, 0.5, and 0.15 μCi of 32P. Treatment effect was assessed by histological analysis 28 days after stent placement. Neointimal and medial smooth muscle cell density were inversely related to increasing stent activity. The neointima of the high-activity (3.0- to 23.0- μCi) stents consisted of fibrin, erythrocytes, occasional inflammatory cells, and smooth muscle cells with partial endothelialization of the luminal surface. In the 1.0-μCi stents, the neointima was expanded and consisted of smooth muscle cells and a proteoglycan-rich matrix. The neointima of the low- activity (0.15- and 0.5-μCi) stents was composed of smooth muscle cells and matrix with complete endothelialization of the luminal surface. At low and high stent activities, there was a reduction in neointimal area (low, 1.63±0.67 mm 2 and high, 1.73±0.97 mm 2 versus control, 2.40±0.87 mm 2) and percent area stenosis (low, 26±7% and high, 26±12%) compared with control stents (37±12%, P≤.01). The 1.0-μCi stents, however, had greater neointimal formation (4.67±1.50 mm 2) and more luminal narrowing (64±16%) than the control stents (P<.0001). Conclusions: The differential response to the doses of continuous β-particle irradiation used in this experimental model suggests a complex biological interaction of endovascular radiation and vascular repair after stent placement. Further study is required to determine the clinical potential for this therapy to prevent stent restenosis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2364-2368 |
| Number of pages | 5 |
| Journal | Circulation |
| Volume | 94 |
| Issue number | 10 |
| State | Published - 1996 |
| Externally published | Yes |
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Keywords
- arteries
- stenosis
- stents
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
Effects of endovascular radiation from a β-particle-emitting stent in a porcine coronary restenosis model : A dose-response study. / Carter, Andrew J.; Laird, John R.; Bailey, Lynn R.; Hoopes, Timothy G.; Farb, Andrew; Fischell, David R.; Fischell, Robert E.; Fischell, Tim A.; Virmani, Renu.
In: Circulation, Vol. 94, No. 10, 1996, p. 2364-2368.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of endovascular radiation from a β-particle-emitting stent in a porcine coronary restenosis model
T2 - A dose-response study
AU - Carter, Andrew J.
AU - Laird, John R.
AU - Bailey, Lynn R.
AU - Hoopes, Timothy G.
AU - Farb, Andrew
AU - Fischell, David R.
AU - Fischell, Robert E.
AU - Fischell, Tim A.
AU - Virmani, Renu
PY - 1996
Y1 - 1996
N2 - Background: Neointimal formation causes restenosis after intracoronary stent placement. Endovascular radiation delivered via a stent has been shown to reduce neointimal formation after placement in porcine and rabbit iliac arteries. THe objective of this study was to evaluate the dose-related effects of a β-particle-emitting radioactive stent in a porcine coronary restenosis model. Methods and Results: Thirty-seven swine underwent placement of 35 nonradioactive and 39 β-particle-emitting stents with activity levels of 23.0, 14.0, 6.0, 3.0, 1.0, 0.5, and 0.15 μCi of 32P. Treatment effect was assessed by histological analysis 28 days after stent placement. Neointimal and medial smooth muscle cell density were inversely related to increasing stent activity. The neointima of the high-activity (3.0- to 23.0- μCi) stents consisted of fibrin, erythrocytes, occasional inflammatory cells, and smooth muscle cells with partial endothelialization of the luminal surface. In the 1.0-μCi stents, the neointima was expanded and consisted of smooth muscle cells and a proteoglycan-rich matrix. The neointima of the low- activity (0.15- and 0.5-μCi) stents was composed of smooth muscle cells and matrix with complete endothelialization of the luminal surface. At low and high stent activities, there was a reduction in neointimal area (low, 1.63±0.67 mm 2 and high, 1.73±0.97 mm 2 versus control, 2.40±0.87 mm 2) and percent area stenosis (low, 26±7% and high, 26±12%) compared with control stents (37±12%, P≤.01). The 1.0-μCi stents, however, had greater neointimal formation (4.67±1.50 mm 2) and more luminal narrowing (64±16%) than the control stents (P<.0001). Conclusions: The differential response to the doses of continuous β-particle irradiation used in this experimental model suggests a complex biological interaction of endovascular radiation and vascular repair after stent placement. Further study is required to determine the clinical potential for this therapy to prevent stent restenosis.
AB - Background: Neointimal formation causes restenosis after intracoronary stent placement. Endovascular radiation delivered via a stent has been shown to reduce neointimal formation after placement in porcine and rabbit iliac arteries. THe objective of this study was to evaluate the dose-related effects of a β-particle-emitting radioactive stent in a porcine coronary restenosis model. Methods and Results: Thirty-seven swine underwent placement of 35 nonradioactive and 39 β-particle-emitting stents with activity levels of 23.0, 14.0, 6.0, 3.0, 1.0, 0.5, and 0.15 μCi of 32P. Treatment effect was assessed by histological analysis 28 days after stent placement. Neointimal and medial smooth muscle cell density were inversely related to increasing stent activity. The neointima of the high-activity (3.0- to 23.0- μCi) stents consisted of fibrin, erythrocytes, occasional inflammatory cells, and smooth muscle cells with partial endothelialization of the luminal surface. In the 1.0-μCi stents, the neointima was expanded and consisted of smooth muscle cells and a proteoglycan-rich matrix. The neointima of the low- activity (0.15- and 0.5-μCi) stents was composed of smooth muscle cells and matrix with complete endothelialization of the luminal surface. At low and high stent activities, there was a reduction in neointimal area (low, 1.63±0.67 mm 2 and high, 1.73±0.97 mm 2 versus control, 2.40±0.87 mm 2) and percent area stenosis (low, 26±7% and high, 26±12%) compared with control stents (37±12%, P≤.01). The 1.0-μCi stents, however, had greater neointimal formation (4.67±1.50 mm 2) and more luminal narrowing (64±16%) than the control stents (P<.0001). Conclusions: The differential response to the doses of continuous β-particle irradiation used in this experimental model suggests a complex biological interaction of endovascular radiation and vascular repair after stent placement. Further study is required to determine the clinical potential for this therapy to prevent stent restenosis.
KW - arteries
KW - stenosis
KW - stents
UR - http://www.scopus.com/inward/record.url?scp=0029807407&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029807407&partnerID=8YFLogxK
M3 - Article
C2 - 8921774
AN - SCOPUS:0029807407
VL - 94
SP - 2364
EP - 2368
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 10
ER -