Radioactive stents delay but do not prevent in-stent neointimal hyperplasia

I. Patrick Kay, Alexander J. Wardeh, Ken Kozuma, David P. Foley, A. H.Marco Knook, Attila Thury, George Sianos, Willem J. Van Der Giessen, Peter C. Levendag, Patrick W. Serruys

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70 Citations (Scopus)

Abstract

Background - Restenosis after conventional stenting is almost exclusively caused by neointimal hyperplasia. β-Particle-emitting radioactive stents decrease in-stent neointimal hyperplasia at 6-month follow-up. The purpose of this study was to evaluate the 1-year outcome of 32P radioactive stents with an initial activity of 6 to 12 μCi using serial quantitative coronary angiography and volumetric ECG-gated 3D intravascular ultrasound (IVUS). Methods and Results - Of 40 patients undergoing initial stent implantation, 26 were event-free after the 6-month follow-up period and 22 underwent repeat catheterization and IVUS at 1 year; they comprised half of the study population. Significant luminal deterioration was observed within the stents between 6 months and 1 year, as evidenced by a decrease in the angiographic minimum lumen diameter (-0.43±0.56 mm; P=0.028) and in the mean lumen diameter in the stent (-0.55±0.63 mm; P=0.001); a significant increase in in-stent neointimal hyperplasia by IVUS (18.16±12.59 mm3 at 6 months to 27.75±11.99 mm3 at 1 year; P=0.001) was also observed. Target vessel revascularization was performed in 5 patients (23%). No patient experienced late occlusion, myocardial infarction, or death. By 1 year, 21 of the initial 40 patients (65%) remained event-free. Conclusions - Neointimal proliferation is delayed rather than prevented by radioactive stent implantation. Clinical outcome 1 year after the implantation of stents with an initial activity of 6 to 12 μCi is not favorable when compared with conventional stenting.

Original languageEnglish
Pages (from-to)14-17
Number of pages4
JournalCirculation
Volume103
Issue number1
DOIs
Publication statusPublished - Jan 9 2001

Keywords

  • Angiography
  • Radioisotopes
  • Restenosis
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Kay, I. P., Wardeh, A. J., Kozuma, K., Foley, D. P., Knook, A. H. M., Thury, A., Sianos, G., Van Der Giessen, W. J., Levendag, P. C., & Serruys, P. W. (2001). Radioactive stents delay but do not prevent in-stent neointimal hyperplasia. Circulation, 103(1), 14-17. https://doi.org/10.1161/01.CIR.103.1.14