Initial observation regarding changes in vessel dimensions after balloon angioplasty and stenting followed by catheter-based beta-radiation. Is stenting necessary in the setting of catheter-based radiotherapy?
AIMS: We sought to compare the effect of intracoronary beta-radiation on the vessel dimensions in de novo lesions using three-dimensional intravascular ultrasound quantification after balloon angioplasty and stenting. METHODS AND RESULTS: Forty patients (44 vessels; 28 balloon angioplasty and 16 stenting) treated with catheter-based beta-radiation and 18 non-irradiated control patients (18 vessels; 10 balloon angioplasty and 8 stenting) were investigated by means of three-dimensional volumetric intravascular ultrasound analysis post-procedure and at 6-8 months follow-up. Total vessel (EEM) volume enlarged after both balloon angioplasty and stenting (+37 mm(3) vs +42 mm(3), P=ns), but vessel wall volume (plaque plus media) also increased similarly (+33 mm(3) vs +49 mm(3), P=ns) in the irradiated patients. Lumen volume remained unchanged in both groups (+3 mm(3) vs -7 mm(3), P=ns). In the stent-covered segments, neointima at follow-up was significantly smaller in the irradiated group than the control group (8 mm(3) vs 27 mm(3), P=0.001, respectively), but the total amount of tissue growth was similar in both groups (33 mm(3) vs 29 mm(3), P=ns). CONCLUSIONS: Intracoronary beta-radiation induces vessel enlargement after balloon angioplasty and/or stenting, accommodating tissue growth. Additional stenting may not play an important role in the prevention of constrictive remodelling in the setting of catheter-based intracoronary beta-radiotherapy.
|Keywords||*Angioplasty, Transluminal, Percutaneous Coronary, *Heart Catheterization, *Observation, *Stents, Aged, Beta Rays, Blood Vessel Prosthesis Implantation, Comparative Study, Coronary Restenosis/etiology, Coronary Stenosis/complications/therapy, Coronary Vessels/radiation effects/*surgery/ultrasonography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Research Support, Non-U.S. Gov't, Treatment Outcome, Ultrasonography, Interventional|
|Persistent URL||dx.doi.org/10.1053/euhj.2001.2899, hdl.handle.net/1765/13059|
Kozuma, K., Costa, M.A., van der Giessen, W.J., Sabaté, M., Ligthart, J.M.R., Coen, V.L.M.A., … Serruys, P.W.J.C.. (2002). Initial observation regarding changes in vessel dimensions after balloon angioplasty and stenting followed by catheter-based beta-radiation. Is stenting necessary in the setting of catheter-based radiotherapy?. European Heart Journal, 23(8), 641–649. doi:10.1053/euhj.2001.2899