Direct Stenting Versus Direct Stenting Followed by Centered Beta-Radiation With Intravascular Ultrasound-Guided Dosimetry and Long-Term Anti-Platelet Treatment

Serruys, Patrick W.; Wijns, William; Sianos, Georgios; Scheerder, Ivan De; Heuvel, P. A. Van Den; Rutsch, Wolfgang; Glogar, Helmut D.; Macaya, Carlos; Materne, P.; Veldhof, Susan; Vonhausen, Heike; Otto-Terlouw, Patricia C.; Giessen, Wim J. van der

doi:10.1016/j.jacc.2004.03.077

Cited by 29 publications

(2 citation statements)

References 39 publications

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“…Almost all trials examining the effects of intracoronary beta radiation have been generally unsuccessful, showing a reduced incidence of restenosis but an increased rate of thrombotic vessel occlusion [34], probably as a consequence of delayed reendothelialization [35].…”

Section: Current Approaches To Prevent Resteno-sismentioning

confidence: 99%

Porphyrin-Photosensitized Processes: Their Applications in the Prevention of Arterial Restenosis

Magaraggia

Marigo²,

Pagnan³

et al. 2007

CHAMC

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Photodynamic therapy (PDT) is based on the use of a photozensitising compound which is accumulated by rapidly proliferating cells. Subsequent irradiation with light wavelengths specifically absorbed by the photosensitiser promotes the generation of reactive short-lived oxygen species which cause an irreversible and selective damage. Endovascular interventions to correct obstructive arterial disease have been developed worldwide with excellent short term results. However, long term patency is still limited by the onset of restenosis, due to subsequent intimal hyperplasia (IH). IH is characterized by proliferation and migration of smooth muscle cells (SMC) and extracellular matrix production. Targeting of SMC by photozensitisers can be efficiently achieved by taking advantage of the receptors for low density lipoproteins (LDL) expressed by such cells. Thus, preference is given to hydrophobic compounds which readily partition in the lipid matrix of LDL. We developed a liposomal formulation of a highly hydrophobic photozensitising agent, Zn(II)-phthalocyanine (ZnPc). The liposome-delivered ZnPc was readily taken up by cultured SMC cells and preferentially localized in the Golgi apparatus. Red light irradiation of incubated SMC induced cell death. Extension of these investigations to an in vivo rabbit model showed that ZnPc mainly accumulated in the media layer, where PDT induces the main damage through cellular depletion due to apoptosis of SMC, changes in the extracellular matrix with generation of a barrier to cellular migration, and acceleration of re-endothelization. Initial clinical applications showed that PDT safely and effectively prevents restenosis after angioplasty up to a 6 month follow-up.

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Section: Current Approaches To Prevent Resteno-sismentioning

confidence: 99%

Porphyrin-Photosensitized Processes: Their Applications in the Prevention of Arterial Restenosis

Magaraggia

Marigo²,

Pagnan³

et al. 2007

CHAMC

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show abstract

“…Two trials of intracoronary brachytherapy for the treatment of de novo lesions brought mixed results (107,108). These studies were designed to study the effect of beta-radiation after stenting to prevent restenosis.…”

Section: Predictors and Treatment Of Des Restenosismentioning

confidence: 99%

The year in interventional cardiology

O’Neill

Dixon

Grines

2005

Journal of the American College of Cardiology

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Brachytherapy

Waksman¹

Contemporary Cardiology

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Direct Stenting Versus Direct Stenting Followed by Centered Beta-Radiation With Intravascular Ultrasound-Guided Dosimetry and Long-Term Anti-Platelet Treatment

Abstract: Despite the optimization of pre-, peri-, and post-procedural factors and despite the relative efficacy of the brachytherapy for the prevention of the intra-stent neo-intimal hyperplasia, the clinical outcome of the irradiated group was less favorable than that of the control group.

Cited by 29 publications

References 39 publications

Porphyrin-Photosensitized Processes: Their Applications in the Prevention of Arterial Restenosis

Porphyrin-Photosensitized Processes: Their Applications in the Prevention of Arterial Restenosis

The year in interventional cardiology

Brachytherapy

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