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European Heart Journal 2002 23(8):641-649; doi:10.1053/euhj.2001.2899
Copyright © 2002 by the European Society of Cardiology.
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Initial observation regarding changes in vessel dimensions after balloon angioplasty and stenting followed by catheter-based ß-radiation. Is stenting necessary in the setting of catheter-based radiotherapy?

K. Kozumaa, M.A. Costaa, W.J. van der Giessena, M. Sabatéa, J.M.R. Ligtharta, V.L.M.A. Coenb, I.P. Kaya, A.J. Wardeha, A.H.M. Knooka, P.J de Feytera, P.C. Levendagb and P.W. Serruysa,f1

a Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
b Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

revised July 10, 2001; accepted July 11, 2001

Abstract

Aims We sought to compare the effect of intracoronary ß-radiation on the vessel dimensions in de novo lesions using three-dimensional intravascular ultrasound quantification after balloon angioplasty and stenting.

Methods and Results Forty patients (44 vessels; 28 balloon angioplasty and 16 stenting) treated with catheter-based ß-radiation and 18 non-irradiated control patients (18 vessels; 10 balloon angioplasty and 8 stenting) were investigated by means of three-dimensional volumetric intravascular ultrasound analysis post-procedure and at 6–8 months follow-up. Total vessel (EEM) volume enlarged after both balloon angioplasty and stenting (+37mm3 vs +42mm3, P=ns), but vessel wall volume (plaque plus media) also increased similarly (+33mm3 vs +49mm3, P=ns) in the irradiated patients. Lumen volume remained unchanged in both groups (+3mm3 vs –7mm3, P=ns). In the stent-covered segments, neointima at follow-up was significantly smaller in the irradiated group than the control group (8mm3 vs 27mm3,P =0.001, respectively), but the total amount of tissue growth was similar in both groups (33mm3 vs 29mm3, P=ns).

Conclusions Intracoronary ß-radiation induces vessel enlargement after balloon angioplasty and/or stenting, accommodating tissue growth. Additional stenting may not play an important role in the prevention of constrictive remodelling in the setting of catheter-based intracoronary ß-radiotherapy.

Key Words: Coronary angioplasty, stent, brachytherapy, intravascular ultrasound

f1 Correspondence: Prof. Patrick W. Serruys, MD, PhD, FACC, FESC, Department of Interventional Cardiology, University Hospital Rotterdam Dijkzigt, Thoraxcenter Bd406, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.


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