The effects of 188 rhenium-filled balloon dilation following bare stent placement in a rabbit oesophageal model.
The objective of the study was to evaluate the efficacy of beta-radiation using a rhenium-188-mercaptoacetyltriglycine ((188)Re-MAG(3))-filled balloon for preventing tissue hyperplasia secondary to bare stent placement in a rabbit oesophageal model. Immediately following bare stent placement in 30 rabbits, 10 underwent conventional contrast-filled balloon dilation (control group, Group I), and 20 underwent (188)Re-MAG(3)-filled balloon dilation, with half of these receiving 20 Gy (Group II) and half receiving 40 Gy (Group III) at a 1 mm tissue depth. Diameter percentage stenosis was calculated using oesophagography performed before sacrifice 6 weeks later. Gross and microscopic findings were obtained at both an area of untreated oesophageal tissue and a mid-stent area. Apoptosis and an apoptotic index in the mid-stent area were evaluated in two rabbits from each group. 13 rabbits survived the scheduled 6-week stent placement. Diameter percentage stenosis for Groups II and III was significantly lower than for Group I. The oesophageal mucosa showed nodularity in Group I and smoothness in Groups II and III. Oesophageal mucosal erythema (n = 9) and perforations (n = 10) were observed in Groups II and III only. Mid-stent epithelial layer thickness and muscularis propria destruction differed between the three groups (p<0.05). Apoptosis was increased and the apoptotic index was higher in Groups II and III than in Group I. In conclusion, (188)Re-MAG(3)-filled balloon dilation was effective in preventing tissue hyperplasia secondary to bare stent placement, but at the cost of an increased risk of radiation-induced mucosal inflammation and perforation, in a rabbit oesophageal model. Apoptosis may be the mechanism underlying this irradiation-induced suppression of tissue hyperplasia.
Shin
J H
JH
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul, Korea. jhshin@amc.seoul.kr
Lee
S K
SK
Song
H-Yo
HY
Kim
J-S
JS
Choe
H
H
Kim
E-H
EH
Lee
I J
IJ
Kim
T-H
TH
Kim
E-Y
EY
Woo
C-W
CW
Nah
K Hoon
KH
D000818:Animals; D002404:Catheterization; D004947:Esophagus / Q000528:radiation effects*; D006965:Hyperplasia / Q000517:prevention & control; D009842:Oligopeptides / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use; D011817:Rabbits; D011868:Radioisotopes / Q000627:therapeutic use*; D012211:Rhenium / Q000627:therapeutic use*; D015607:Stents
D009842:Oligopeptides; D009942:Organometallic Compounds; D011868:Radioisotopes; C114893:rhenium-mercaptoacetyltriglycine; D012211:Rhenium