Inhibition of neointimal hyperplasia after stent placement with rhenium 188-filled balloon dilation in a canine iliac artery model.
OBJECTIVE
To evaluate the efficacy of beta-irradiation therapy with rhenium 188 ((188)Re) mercaptoacetyltriglycine (MAG3)-filled balloon dilation to prevent neointimal hyperplasia after stent placement in a canine iliac artery model.


METHODS
A total of 15 stents were implanted into the iliac arteries of eight dogs (one or two stents in each dog). Rhenium 188 MAG3-filled balloon dilation was performed immediately after placement of 10 bare stents-20 Gy in group II (n = 5) and 40 Gy in group III (n = 5)-and conventional balloon dilation was performed immediately after placement of the remaining five bare stents (group I). A follow-up angiogram was obtained 8 weeks after the procedure, and percentage of luminal stenosis was calculated for the proximal and distal ends of each stent. Neointimal thickening (expressed as the neointimal area divided by the sum of neointimal area and media area) was assessed for microscopic examination.


RESULTS
All eight dogs survived until they were euthanized 8 weeks after the procedures. The mean luminal stenosis measurements at 8-week follow-up angiography in groups I, II, and III were 26.63%, -0.44%, and 10.53%, respectively. The mean neointimal thickening measurements in groups I, II, and III were 0.77, 0.21, and 0.34, respectively. The mean percentage of luminal stenosis and neointimal thickening differed significantly among the three groups (P < .05).


CONCLUSIONS
beta-Irradiation with (188)Re-MAG3-filled balloon dilation has the potential to reduce neointimal hyperplasia secondary to stent placement in a canine iliac artery model. A dose of 20 Gy may be preferable versus a dose of 40 Gy to reduce neointimal hyperplasia.
Kim
Tae-Hyung
TH
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Shin
Ji Hoon
JH
Oh
Seung-Jun
SJ
Park
In Kook
IK
Woo
Chul-Woong
CW
Han
Kyung Hee
KH
Dong
Kyung-Rae
KR
D000818:Animals; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002404:Catheterization / Q000379:methods; D004195:Disease Models, Animal; D004285:Dogs; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000532:radiotherapy*; D006801:Humans; D007083:Iliac Artery / Q000528:radiation effects* / Q000601:surgery*; D007554:Isotopes / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D012211:Rhenium / Q000627:therapeutic use*; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome
D007554:Isotopes; D019275:Radiopharmaceuticals; D012211:Rhenium