title: The effects of 188 rhenium-filled balloon dilation following bare stent placement in a rabbit oesophageal model.
abstract: 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.
authors.affiliation: 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
authors.forename: J H
authors.initials: JH
authors.lastname: Shin
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.forename: H-Yo
authors.initials: HY
authors.lastname: Song
authors.forename: J-S
authors.initials: JS
authors.lastname: Kim
authors.forename: H
authors.initials: H
authors.lastname: Choe
authors.forename: E-H
authors.initials: EH
authors.lastname: Kim
authors.forename: I J
authors.initials: IJ
authors.lastname: Lee
authors.forename: T-H
authors.initials: TH
authors.lastname: Kim
authors.forename: E-Y
authors.initials: EY
authors.lastname: Kim
authors.forename: C-W
authors.initials: CW
authors.lastname: Woo
authors.forename: K Hoon
authors.initials: KH
authors.lastname: Nah
mesh_terms: 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
chemical_list: D009842:Oligopeptides; D009942:Organometallic Compounds; D011868:Radioisotopes; C114893:rhenium-mercaptoacetyltriglycine; D012211:Rhenium