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?
OBJECTIVE
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.


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.
Kozuma
K
K
Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Costa
M A
MA
van der Giessen
W J
WJ
Sabaté
M
M
Ligthart
J M R
JM
Coen
V L M A
VL
Kay
I P
IP
Wardeh
A J
AJ
Knook
A H M
AH
de Feyter
P J
PJ
Levendag
P C
PC
Serruys
P W
PW
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001610:Beta Particles; D019917:Blood Vessel Prosthesis Implantation; D006328:Cardiac Catheterization; D023903:Coronary Restenosis / Q000209:etiology; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000528:radiation effects / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional