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Absence of full-stent endothelialization 3 months after gamma radiation
Cardiovascular Radiation Medicine 2 (2001) 263
Absence of full-stent endothelialization 3 months after gamma radiation E. Cheneau* Vascular Laboratory, Cardiovascular Research Institute, Washington Hospital Center, 110 Irving Street Northwest, Washington, DC 20010, USA
Vascular brachytherapy (VBT) has demonstrated effectiveness in the reduction of recurrence of restenosis in multiple clinical trials [1 –3]. However, unusually high rates of late occlusions have been reported in arteries treated by VBT [4]. Delay in re-endothelialization might explain the thrombogenicity of arteries treated with VBT. Following stent implantation, rabbit iliac arteries have been radiated with 192Ir at 30 Gy. Animals were sacrificed at
Fig. 1. (A) Endothelial cells partially cover the luminal surface (1); however, considerably large non-endothelialized areas (2) with exposed stent struts (3) were observed. (B) Adhesion of macrophages, lymphocytes, and platelets on the surface of stent struts not covered by endothelial cells.
3 months and arteries were analyzed by scanning electron microscopy. We found that arteries were incompletely endothelialized at 3 months (Fig. 1).
References [1] Teirstein PS, Massullo V, Jani S, Popma JJ, Mintz GS, Russo RJ, Schatz RA, Guarneri EM, Steuterman S, Morris NB, Leon MB, Tripuraneni P. Catheter-based radiotherapy to inhibit restenosis after coronary stenting. N Engl J Med 1997;336:1697 – 703. [2] Waksman R, White RL, Chan RC, Bass BG, Geirlach L, Mintz GS, Satler LF, Mehran R, Serruys PW, Lansky AJ, Fitzgerald P, Bhargava B, Kent KM, Pichard AD, Leon MB. Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis. Circulation 2000;101:2165 – 71. [3] Waksman R, Bhargava B, White L, Chan RC, Mehran R, Lansky AJ, Mintz GS, Satler LF, Pichard AD, Leon MB, Kent KK. Intra-coronary beta-radiation therapy inhibits recurrence of in-stent restenosis. Circulation 2000;101:1895 – 8. [4] Waksman R, Bhargava B, Mintz GS, Mehran R, Lansky AJ, Satler LF, Pichard AD, Kent KM, Leon MB. Late total occlusion after intracoronary brachytherapy for patients with in-stent restenosis. J Am Coll Cardiol 2000;36:65 – 6.
* Tel.: +1-202-877-5909; fax: +1-202-877-3997. 1522-1865/01/$ – see front matter D 2002 Elsevier Science Inc. All rights reserved. PII: S 1 5 2 2 - 1 8 6 5 ( 0 2 ) 0 0 1 0 8 - 7
Absence of full-stent endothelialization 3 months after gamma radiation E. Cheneau* Vascular Laboratory, Cardiovascular Research Institute, Washington Hospital Center, 110 Irving Street Northwest, Washington, DC 20010, USA
Vascular brachytherapy (VBT) has demonstrated effectiveness in the reduction of recurrence of restenosis in multiple clinical trials [1 –3]. However, unusually high rates of late occlusions have been reported in arteries treated by VBT [4]. Delay in re-endothelialization might explain the thrombogenicity of arteries treated with VBT. Following stent implantation, rabbit iliac arteries have been radiated with 192Ir at 30 Gy. Animals were sacrificed at
Fig. 1. (A) Endothelial cells partially cover the luminal surface (1); however, considerably large non-endothelialized areas (2) with exposed stent struts (3) were observed. (B) Adhesion of macrophages, lymphocytes, and platelets on the surface of stent struts not covered by endothelial cells.
3 months and arteries were analyzed by scanning electron microscopy. We found that arteries were incompletely endothelialized at 3 months (Fig. 1).
References [1] Teirstein PS, Massullo V, Jani S, Popma JJ, Mintz GS, Russo RJ, Schatz RA, Guarneri EM, Steuterman S, Morris NB, Leon MB, Tripuraneni P. Catheter-based radiotherapy to inhibit restenosis after coronary stenting. N Engl J Med 1997;336:1697 – 703. [2] Waksman R, White RL, Chan RC, Bass BG, Geirlach L, Mintz GS, Satler LF, Mehran R, Serruys PW, Lansky AJ, Fitzgerald P, Bhargava B, Kent KM, Pichard AD, Leon MB. Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis. Circulation 2000;101:2165 – 71. [3] Waksman R, Bhargava B, White L, Chan RC, Mehran R, Lansky AJ, Mintz GS, Satler LF, Pichard AD, Leon MB, Kent KK. Intra-coronary beta-radiation therapy inhibits recurrence of in-stent restenosis. Circulation 2000;101:1895 – 8. [4] Waksman R, Bhargava B, Mintz GS, Mehran R, Lansky AJ, Satler LF, Pichard AD, Kent KM, Leon MB. Late total occlusion after intracoronary brachytherapy for patients with in-stent restenosis. J Am Coll Cardiol 2000;36:65 – 6.
* Tel.: +1-202-877-5909; fax: +1-202-877-3997. 1522-1865/01/$ – see front matter D 2002 Elsevier Science Inc. All rights reserved. PII: S 1 5 2 2 - 1 8 6 5 ( 0 2 ) 0 0 1 0 8 - 7