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Catheter‐based 32 P β‐radiation after stent implantation in porcine coronary arteries: Role of source‐centering and geographical miss
Author(s) -
Maeng Michael,
Busk Martin,
Tanderup Kari,
Mertz Henrik,
Andersen Henning Rud,
Thuesen Leif
Publication year - 2003
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.10608
Subject(s) - medicine , brachytherapy , neointima , restenosis , stent , coronary arteries , stenosis , intravascular ultrasound , radiology , nuclear medicine , artery , radiation therapy , cardiology
The present study examined the role of source‐centering and geographical miss in vascular brachytherapy. After implantation of 13 mm long stents, 38 coronary arteries in 13 pigs were randomly assigned to centered brachytherapy (n = 13), eccentric brachytherapy (n = 13), or no radiation (n = 12). Geographical miss was avoided by careful placement of a 27 mm 32 P β‐radiation source. Restenosis was quantified by angiography, histomorphometry, and intravascular ultrasound at 28 days. Source‐centering led to a significant ( P < 0.001) reduction of in‐stent area stenosis (centered radiation, 12% ± 5%; eccentric radiation, 37% ± 21%; control arteries, 41% ± 13%). Despite 7 mm coverage of the edge segments, radiation was found to induce edge stenosis due to neointima formation and constrictive vascular remodeling. We conclude that centered radiation was superior to eccentric radiation in reducing in‐stent luminal narrowing while radiation‐induced edge stenosis was still observed despite extension of the radiation zone to 7 mm beyond the stent edges. Catheter Cardiovasc Interv 2003;60:247–257. © 2003 Wiley–Liss, Inc.