[The role of ionized radiation in prevention of restenosis after coronary angioplasty].
Restenosis occurs to be an Achilles heel of coronary interventions. Three overlapping processes: elastic recoil, neointimal proliferation and arterial remodelling are responsible for development of arterial renarrowing. The only method which proved efficient in reducing the restenosis rate is coronary stenting. Stents deployed using high pressure technique diminish restenosis rate by about one third. Stents eliminate elastic recoil and arterial remodelling but aggravate neointimal proliferation. A concept of radiation therapy was introduced to solve the problem of neointimal hyperplasia. Experiments on animal models of restenosis proved that both gamma as well as beta irradiation inhibited neointimal proliferation after arterial injury. Results of experimental investigations concerning both intraarterial irradiation during angioplasty as well as radioactive stent implantation are reviewed. Authors discuss also results of first clinical trials, the design and preliminary results of some larger studies like PARIS, SCRIPPS, GENEVA, BERT, IRIS, WRIST. Further investigational directions in intravascular radiation therapy are also presented.
Przewłocki
T
T
Kliniki Chorób Serca i Naczyń, Instytutu Kardiologii Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Pieniazek
P
P
Tracz
W
W
Kostkiewicz
M
M
Olszowska
M
M
Podolec
P
P
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D003327:Coronary Disease / Q000532:radiotherapy* / Q000628:therapy; D006801:Humans; D055502:Secondary Prevention; D015607:Stents
Rola promieniowania jonizujacego w zapobieganiu nawrotowi zwezenia po angioplastyce wieńcowej.