"Edge Effect" of (32)p radioactive stents is caused by the combination of chronic stent injury and radioactive dose falloff
Radioactive stents have been reported to reduce in-stent neointimal thickening. An unexpected increase in neointimal response was observed, however, at the stent-to-artery transitions, the so-called "edge effect." To investigate the factors involved in this edge effect, we studied stents w...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2001-10, Vol.104 (18), p.2236 |
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| creator | van Der Giessen, W J Regar, E Harteveld, M S Coen, V L Bhagwandien, R Au, A Levendag, P C Ligthart, J Serruys, P W den Boer, A Verdouw, P D Boersma, E Hu, T van Beusekom, H M |
| description | Radioactive stents have been reported to reduce in-stent neointimal thickening. An unexpected increase in neointimal response was observed, however, at the stent-to-artery transitions, the so-called "edge effect." To investigate the factors involved in this edge effect, we studied stents with 1 radioactive half and 1 regular nonradioactive half, thereby creating a midstent radioactive dose-falloff zone next to a nonradioactive stent-artery transition at one side and a radioactive stent-artery transition at the other side.
Half-radioactive stents (n=20) and nonradioactive control stents (n=10) were implanted in the coronary arteries of Yucatan micropigs. Animals received aspirin and clopidogrel as antithrombotics. After 4 weeks, a significant midstent stenosis was observed by angiography in the half-radioactive stents. Two animals died suddenly because of coronary occlusion at this mid zone at 8 and 10 weeks. At 12-week follow-up angiography, intravascular ultrasound and histomorphometry showed a significant neointimal thickening at the midstent dose-falloff zone of the half-radioactive stents, but not at the stent-to-artery transitions at both extremities. Such a midstent response (mean angiographic late loss 1.0 mm) was not observed in the nonradioactive stents (mean loss 0.4 to 0.6 mm; P< 0.01).
The edge effect of high-dose radioactive stents in porcine coronary arteries is associated with the combination of stent injury and radioactive dose falloff. |
| doi_str_mv | 10.1161/hc4301.097873 |
| format | Article |
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Half-radioactive stents (n=20) and nonradioactive control stents (n=10) were implanted in the coronary arteries of Yucatan micropigs. Animals received aspirin and clopidogrel as antithrombotics. After 4 weeks, a significant midstent stenosis was observed by angiography in the half-radioactive stents. Two animals died suddenly because of coronary occlusion at this mid zone at 8 and 10 weeks. At 12-week follow-up angiography, intravascular ultrasound and histomorphometry showed a significant neointimal thickening at the midstent dose-falloff zone of the half-radioactive stents, but not at the stent-to-artery transitions at both extremities. Such a midstent response (mean angiographic late loss 1.0 mm) was not observed in the nonradioactive stents (mean loss 0.4 to 0.6 mm; P< 0.01).
The edge effect of high-dose radioactive stents in porcine coronary arteries is associated with the combination of stent injury and radioactive dose falloff.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/hc4301.097873</identifier><identifier>PMID: 11684637</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Animals ; Blood Vessel Prosthesis Implantation ; Coronary Angiography ; Coronary Vessels - pathology ; Coronary Vessels - radiation effects ; Coronary Vessels - surgery ; Disease Models, Animal ; Disease Progression ; Dose-Response Relationship, Radiation ; Drug Implants ; Female ; Graft Occlusion, Vascular - etiology ; Graft Occlusion, Vascular - pathology ; Graft Occlusion, Vascular - prevention & control ; Implants, Experimental ; Phosphorus Radioisotopes - administration & dosage ; Stents - adverse effects ; Swine, Miniature ; Tunica Intima - pathology ; Tunica Intima - radiation effects ; Vascular Patency - radiation effects</subject><ispartof>Circulation (New York, N.Y.), 2001-10, Vol.104 (18), p.2236</ispartof><rights>Copyright American Heart Association, Inc. Oct 30, 2001</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11684637$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Der Giessen, W J</creatorcontrib><creatorcontrib>Regar, E</creatorcontrib><creatorcontrib>Harteveld, M S</creatorcontrib><creatorcontrib>Coen, V L</creatorcontrib><creatorcontrib>Bhagwandien, R</creatorcontrib><creatorcontrib>Au, A</creatorcontrib><creatorcontrib>Levendag, P C</creatorcontrib><creatorcontrib>Ligthart, J</creatorcontrib><creatorcontrib>Serruys, P W</creatorcontrib><creatorcontrib>den Boer, A</creatorcontrib><creatorcontrib>Verdouw, P D</creatorcontrib><creatorcontrib>Boersma, E</creatorcontrib><creatorcontrib>Hu, T</creatorcontrib><creatorcontrib>van Beusekom, H M</creatorcontrib><title>"Edge Effect" of (32)p radioactive stents is caused by the combination of chronic stent injury and radioactive dose falloff</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Radioactive stents have been reported to reduce in-stent neointimal thickening. An unexpected increase in neointimal response was observed, however, at the stent-to-artery transitions, the so-called "edge effect." To investigate the factors involved in this edge effect, we studied stents with 1 radioactive half and 1 regular nonradioactive half, thereby creating a midstent radioactive dose-falloff zone next to a nonradioactive stent-artery transition at one side and a radioactive stent-artery transition at the other side.
Half-radioactive stents (n=20) and nonradioactive control stents (n=10) were implanted in the coronary arteries of Yucatan micropigs. Animals received aspirin and clopidogrel as antithrombotics. After 4 weeks, a significant midstent stenosis was observed by angiography in the half-radioactive stents. Two animals died suddenly because of coronary occlusion at this mid zone at 8 and 10 weeks. At 12-week follow-up angiography, intravascular ultrasound and histomorphometry showed a significant neointimal thickening at the midstent dose-falloff zone of the half-radioactive stents, but not at the stent-to-artery transitions at both extremities. Such a midstent response (mean angiographic late loss 1.0 mm) was not observed in the nonradioactive stents (mean loss 0.4 to 0.6 mm; P< 0.01).
The edge effect of high-dose radioactive stents in porcine coronary arteries is associated with the combination of stent injury and radioactive dose falloff.</description><subject>Animals</subject><subject>Blood Vessel Prosthesis Implantation</subject><subject>Coronary Angiography</subject><subject>Coronary Vessels - pathology</subject><subject>Coronary Vessels - radiation effects</subject><subject>Coronary Vessels - surgery</subject><subject>Disease Models, Animal</subject><subject>Disease Progression</subject><subject>Dose-Response Relationship, Radiation</subject><subject>Drug Implants</subject><subject>Female</subject><subject>Graft Occlusion, Vascular - etiology</subject><subject>Graft Occlusion, Vascular - pathology</subject><subject>Graft Occlusion, Vascular - prevention & control</subject><subject>Implants, Experimental</subject><subject>Phosphorus Radioisotopes - administration & dosage</subject><subject>Stents - adverse effects</subject><subject>Swine, Miniature</subject><subject>Tunica Intima - pathology</subject><subject>Tunica Intima - radiation effects</subject><subject>Vascular Patency - radiation effects</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkM1LAzEUxIMotlaPXiX0pIet-5LspnuUUj-g4KX3JR8vNqXdrJusUPznXWk9eJoZ-M08eITcQj4DKOFxYwTPYZZXci75GRlDwUQmCl6dk3Ge51UmOWMjchXjdogll8UlGQ3NuRj8mHxPl_YD6dI5NGlKg6P3nD20tFPWB2WS_0IaEzYpUh-pUX1ES_WBpg1SE_baNyr50PwWzaYLjTdHnPpm23cHqhr7b8uGiNSp3S44d00uBhfx5qQTsn5erhev2er95W3xtMpaEFXKCiicqUwlHVjHHQOFpdQahEBrBWNlKVEZA84Zo_U8dwqlRijQMAm84hMyPc62XfjsMaZ6G_quGS7WDFgpJczFAN2doF7v0dZt5_eqO9R_n-I_Bu9rqw</recordid><startdate>20011030</startdate><enddate>20011030</enddate><creator>van Der Giessen, W J</creator><creator>Regar, E</creator><creator>Harteveld, M S</creator><creator>Coen, V L</creator><creator>Bhagwandien, R</creator><creator>Au, A</creator><creator>Levendag, P C</creator><creator>Ligthart, J</creator><creator>Serruys, P W</creator><creator>den Boer, A</creator><creator>Verdouw, P D</creator><creator>Boersma, E</creator><creator>Hu, T</creator><creator>van Beusekom, H M</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope></search><sort><creationdate>20011030</creationdate><title>"Edge Effect" of (32)p radioactive stents is caused by the combination of chronic stent injury and radioactive dose falloff</title><author>van Der Giessen, W J ; Regar, E ; Harteveld, M S ; Coen, V L ; Bhagwandien, R ; Au, A ; Levendag, P C ; Ligthart, J ; Serruys, P W ; den Boer, A ; Verdouw, P D ; Boersma, E ; Hu, T ; van Beusekom, H M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p149t-515fc9c97f1df3f21ae67bb144edd422667eacc1ffccbb80fae7be15ec271393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Animals</topic><topic>Blood Vessel Prosthesis Implantation</topic><topic>Coronary Angiography</topic><topic>Coronary Vessels - pathology</topic><topic>Coronary Vessels - radiation effects</topic><topic>Coronary Vessels - surgery</topic><topic>Disease Models, Animal</topic><topic>Disease Progression</topic><topic>Dose-Response Relationship, Radiation</topic><topic>Drug Implants</topic><topic>Female</topic><topic>Graft Occlusion, Vascular - etiology</topic><topic>Graft Occlusion, Vascular - pathology</topic><topic>Graft Occlusion, Vascular - prevention & control</topic><topic>Implants, Experimental</topic><topic>Phosphorus Radioisotopes - administration & dosage</topic><topic>Stents - adverse effects</topic><topic>Swine, Miniature</topic><topic>Tunica Intima - pathology</topic><topic>Tunica Intima - radiation effects</topic><topic>Vascular Patency - radiation effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Der Giessen, W J</creatorcontrib><creatorcontrib>Regar, E</creatorcontrib><creatorcontrib>Harteveld, M S</creatorcontrib><creatorcontrib>Coen, V L</creatorcontrib><creatorcontrib>Bhagwandien, R</creatorcontrib><creatorcontrib>Au, A</creatorcontrib><creatorcontrib>Levendag, P C</creatorcontrib><creatorcontrib>Ligthart, J</creatorcontrib><creatorcontrib>Serruys, P W</creatorcontrib><creatorcontrib>den Boer, A</creatorcontrib><creatorcontrib>Verdouw, P D</creatorcontrib><creatorcontrib>Boersma, E</creatorcontrib><creatorcontrib>Hu, T</creatorcontrib><creatorcontrib>van Beusekom, H M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Der Giessen, W J</au><au>Regar, E</au><au>Harteveld, M S</au><au>Coen, V L</au><au>Bhagwandien, R</au><au>Au, A</au><au>Levendag, P C</au><au>Ligthart, J</au><au>Serruys, P W</au><au>den Boer, A</au><au>Verdouw, P D</au><au>Boersma, E</au><au>Hu, T</au><au>van Beusekom, H M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>"Edge Effect" of (32)p radioactive stents is caused by the combination of chronic stent injury and radioactive dose falloff</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2001-10-30</date><risdate>2001</risdate><volume>104</volume><issue>18</issue><spage>2236</spage><pages>2236-</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Radioactive stents have been reported to reduce in-stent neointimal thickening. An unexpected increase in neointimal response was observed, however, at the stent-to-artery transitions, the so-called "edge effect." To investigate the factors involved in this edge effect, we studied stents with 1 radioactive half and 1 regular nonradioactive half, thereby creating a midstent radioactive dose-falloff zone next to a nonradioactive stent-artery transition at one side and a radioactive stent-artery transition at the other side.
Half-radioactive stents (n=20) and nonradioactive control stents (n=10) were implanted in the coronary arteries of Yucatan micropigs. Animals received aspirin and clopidogrel as antithrombotics. After 4 weeks, a significant midstent stenosis was observed by angiography in the half-radioactive stents. Two animals died suddenly because of coronary occlusion at this mid zone at 8 and 10 weeks. At 12-week follow-up angiography, intravascular ultrasound and histomorphometry showed a significant neointimal thickening at the midstent dose-falloff zone of the half-radioactive stents, but not at the stent-to-artery transitions at both extremities. Such a midstent response (mean angiographic late loss 1.0 mm) was not observed in the nonradioactive stents (mean loss 0.4 to 0.6 mm; P< 0.01).
The edge effect of high-dose radioactive stents in porcine coronary arteries is associated with the combination of stent injury and radioactive dose falloff.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>11684637</pmid><doi>10.1161/hc4301.097873</doi></addata></record> |
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| identifier | ISSN: 0009-7322 |
| ispartof | Circulation (New York, N.Y.), 2001-10, Vol.104 (18), p.2236 |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Animals Blood Vessel Prosthesis Implantation Coronary Angiography Coronary Vessels - pathology Coronary Vessels - radiation effects Coronary Vessels - surgery Disease Models, Animal Disease Progression Dose-Response Relationship, Radiation Drug Implants Female Graft Occlusion, Vascular - etiology Graft Occlusion, Vascular - pathology Graft Occlusion, Vascular - prevention & control Implants, Experimental Phosphorus Radioisotopes - administration & dosage Stents - adverse effects Swine, Miniature Tunica Intima - pathology Tunica Intima - radiation effects Vascular Patency - radiation effects |
| title | "Edge Effect" of (32)p radioactive stents is caused by the combination of chronic stent injury and radioactive dose falloff |
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