A first trial in the clinical application of photodynamic therapy for the prevention of restenosis after coronary-stent placement.
OBJECTIVE
The aim of this clinical study was to evaluate the safety of local delivery of a photosensitizer followed by photodynamic therapy (PDT), to determine its effectiveness in reducing in-stent restenosis.


METHODS
Porfimer sodium was administered via a local delivery catheter to five coronary-stent implanted lesions followed by irradiation with a pulse laser. Coronary angiography (CAG) was performed at the baseline, after the procedure and at a 6-month follow-up.


RESULTS
By the 18-month clinical follow-up, no adverse events such as photodermatosis, or myocardial ischemia had occurred. At the follow-up, no coronary embolization, dissection, or aneurysmal dilatation was observed in the CAG. In-stent diameter stenosis, late loss, and loss index were 19.16+/-8.20%, 0.37+/-0.18 mm, and 0.19+/-0.12, respectively. No in-stent restenosis was observed.


CONCLUSIONS
This study suggests that PDT, with local delivery of Porfimer sodium, is safe and may be a feasible technique in preventing in-stent restenosis.
Usui
Mikio
M
Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan. m-usui@tokyo-med.ac.jp
Miyagi
Manabu
M
Fukasawa
Shinya
S
Hara
Takeshi
T
Ueyama
Naoya
N
Nakajima
Hitoshi
H
Takata
Ryu
R
Sasame
Atsuko
A
Tamura
Ken
K
Naitou
Yuuichi
Y
Yamashina
Akira
A
D000368:Aged; D000818:Animals; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000517:prevention & control*; D023921:Coronary Stenosis / Q000628:therapy; D017323:Dihematoporphyrin Ether / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D011817:Rabbits; D015607:Stents; D013997:Time Factors
D017319:Photosensitizing Agents; D017323:Dihematoporphyrin Ether