(Circulation. 1999;100:1548-1554.)
© 1999 American Heart Association, Inc.
Basic Science Reports |
Dose-Response Effects of 32P Radioactive Stents in an Atherosclerotic Porcine Coronary Model
From the Cardiology Research Foundation, Washington Hospital Center (A.J.C., D.S., L.B.), Walter Reed Army Medical Center (T.H.), and the Armed Forces Institute of Pathology (R.J., R.V.), Washington, DC.
Correspondence to Andrew J. Carter, DO, Cardiology Research Foundation, Washington Hospital Center, 110 Irving St NW, Suite 4B-1, Washington, DC, 20100. E-mail ajc2{at}mhg.edu
Background—Experimental studies have demonstrated that 32P radioactive stents reduce neointimal formation at 28 days in porcine iliac and coronary arteries. Our objective was to determine the long-term dose-response effects of 1.0- to 12.0-µCi 32P radioactive stents in a porcine atherosclerotic coronary model.
Methods and Results—Control (n=19) and 1.0- to 12.0-µCi
32P radioactive (n=43) stents (total, n=62) were implanted
in the coronary arteries of 31 miniature swine at 28 days after
creation of a fibrocellular plaque by overstretch balloon injury and
cholesterol feeding. Angiography and histomorphometry were
performed at 6 months. Stent thrombosis occurred in 3 radioactive
(7.7%) and no control stents (P=0.54). On histology,
the mean neointimal area and the percent in-stent
stenosis correlated positively with increasing stent activity
(r=0.64, P<0.001). The mean
neointimal area (mm2) for the stents with 
3.0
µCi 32P (3.57±1.21) was significantly greater than that
for the nonradioactive stents (1.78±0.68, P<0.0001).
The neointima of the stents with 3.0 µCi
32P was composed of smooth muscle cells, matrix
proteoglycans, calcification, foam cells, and cholesterol
clefts.
Conclusions—Continuous low-dose-rate irradiation delivered by high-activity 32P radioactive stents promotes the formation of an "atheromatous" neointima after 6 months in this experimental model. These data may be useful for predicting late tissue responses to radioactive stents in human coronary arteries.
Key Words: stents • restenosis • radioisotopes
This article has been cited by other articles:
 |
|
 |
|
  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]
|
|
|
|
 |
|
 R Virmani, F D Kolodgie, A Farb, and A Lafont Drug eluting stents: are human and animal studies comparable? Heart, February 1, 2003; 89(2): 133 - 138. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I.-M. o Chung, H. K. Gold, S. M. Schwartz, Y. Ikari, M. A. Reidy, and T. N. Wight Enhanced extracellular matrix accumulation in restenosis of coronary arteries after stent deployment J. Am. Coll. Cardiol., December 18, 2002; 40(12): 2072 - 2081. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Morino, H. Kaneda, T. Fox, A. Takagi, A. H.M. Hassan, R. Bonan, I. Crocker, A. J. Lansky, W. K. Laskey, M. Suntharalingam, et al. Delivered Dose and Vascular Response After {beta}-Radiation for In-Stent Restenosis: Retrospective Dosimetry and Volumetric Intravascular Ultrasound Analysis Circulation, October 29, 2002; 106(18): 2334 - 2339. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Regar, K. Kozuma, G. Sianos, V.L.M.A. Coen, W.J. van der Giessen, D. Foley, P. de Feyter, B. Rensing, P. Smits, J. Vos, et al. Routine intracoronary beta-irradiation. Acute and one year outcome in patients at high risk for recurrence of stenosis Eur. Heart J., July 1, 2002; 23(13): 1038 - 1044. [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]
|
|
|
|
|
|
W. J. van der Giessen, E. Regar, M. S. Harteveld, V. L.M.A. Coen, R. Bhagwandien, A. Au, P. C. Levendag, J. Ligthart, P. W. Serruys, A. den Boer, et al. "Edge Effect" of 32P Radioactive Stents Is Caused by the Combination of Chronic Stent Injury and Radioactive Dose Falloff Circulation, October 30, 2001; 104(18): 2236 - 2241. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. P. Kay, A. J. Wardeh, K. Kozuma, G. Sianos, E. Regar, M. Knook, W. J. van der Giessen, A. Thury, J. M. R. Ligthart, V. M. A. Coen, et al. The pattern of restenosis and vascular remodelling after cold-end adioactive stent implantation Eur. Heart J., August 1, 2001; 22(15): 1311 - 1317. [Abstract] [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]
|
|
|
|
|
|
H.-S. Kim, R. Waksman, Y. Cottin, M. Kollum, B. Bhargava, R. Mehran, R. C. Chan, and G. S. Mintz Edge stenosis and geographical miss following intracoronary gamma radiation therapy for in-stent restenosis J. Am. Coll. Cardiol., March 15, 2001; 37(4): 1026 - 1030. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. P. Kay, A. J. Wardeh, K. Kozuma, D. P. Foley, A. H. M. Knook, A. Thury, G. Sianos, W. J. van der Giessen, P. C. Levendag, and P. W. Serruys Radioactive Stents Delay but Do Not Prevent In-Stent Neointimal Hyperplasia Circulation, January 2, 2001; 103(1): 14 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kozuma, M. A. Costa, M. Sabate, I. P. Kay, J. P. A. Marijnissen, V. L. M. A. Coen, P. Serrano, J. M. R. Ligthart, P. C. Levendag, and P. W. Serruys Three-Dimensional Intravascular Ultrasound Assessment of Noninjured Edges of {beta}-Irradiated Coronary Segments Circulation, September 26, 2000; 102(13): 1484 - 1489. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. P. Kay, M. Sabate, M. A. Costa, K. Kozuma, M. Albertal, W. J. van der Giessen, A. J. Wardeh, J. M. R. Ligthart, V. M. A. Coen, P. C. Levendag, et al. Positive Geometric Vascular Remodeling Is Seen After Catheter-Based Radiation Followed by Conventional Stent Implantation but Not After Radioactive Stent Implantation Circulation, September 19, 2000; 102(12): 1434 - 1439. [Abstract] [Full Text] [PDF]
|
|