Radioactive beta-emitting solution-filled balloon treatment prevents porcine coronary restenosis.
OBJECTIVE
Intracoronary gamma or beta radiation from centrally located sources at the time of overstretch balloon injury inhibits neointimal proliferation. In an effort to deliver homogeneous, centered radiation fields in a technically straightforward fashion, we studied the effects of a beta-emitting solution used as a balloon inflation fluid to deliver radiation at the time of coronary injury.


METHODS
Twenty-one coronary arteries in 13 juvenile swine underwent irradiation (control and 11 or 25 Gy media dose). Radiation was delivered using a perfusion balloon inflated with an Re-188 solution. Subsequently, overdilatation percutaneous transluminal coronary angioplasty was performed at the pretreated segment. Histopathologic and histomorphometric analysis was performed at 30 days after injury on the entire irradiated artery.


RESULTS
Balloon overdilation was associated with significant vascular injury and marked neointimal proliferation in control and low-dose (11 Gy)-treated arteries. High-dose radiation (25 Gy) significantly inhibited neointima formation compared with controls (neointimal area: 0.49 +/- 0.29 mm2 vs. 1.51 +/- 0.22 mm2, respectively; p = 0.02) and low-dose radiation (neointimal area 1.75 +/- 0.54 mm2, p > 0.1 compared with controls).


CONCLUSIONS
Liquid Re-188 is an effective beta-emitting vehicle to deliver intracoronary radiation and prevent restenosis in this model. Intracoronary radiation treatment using aqueous radioisotope sources is technically straightforward and provides the optimally achievable radiation dose distribution.
Interventional Cardiology Center, Department of Medicine, Columbia-Presbyterian Medical Center, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. jzw1@columbia.edu
J
J
Weinberger
K N
KN
Giedd
A D
AD
Simon
C
C
Marboe
F F
FF
Knapp
F
F
Trichter
H
H
Amols
D000818:Animals; D001610:Beta Particles / Q000627:therapeutic use*; D001918:Brachytherapy / Q000379:methods*; D002404:Catheterization / Q000379:methods; D003327:Coronary Disease / Q000473:pathology / Q000517:prevention & control / Q000532:radiotherapy*; D003331:Coronary Vessels / Q000293:injuries / Q000473:pathology; D011868:Radioisotopes / Q000627:therapeutic use; D012008:Recurrence; D012211:Rhenium / Q000627:therapeutic use; D013552:Swine
D011868:Radioisotopes; D012211:Rhenium