Acta Med. 2004, 47: 37-42

https://doi.org/10.14712/18059694.2018.64

The “Edge Effect” After Implantation of β-Emitting (55Co) Stents with High Initial Activity

Pavel Červinkaa, Josef Šťásekb, Marco Aurelio Costac, Jan Štursad, Miloslav Fišerd, Petr Vodňanskýb, Michaela Kočišováb, Josef Veselkae, Miloslav Pleskotb, Jaroslav Malýf

aMasaryk Hospital, Department of Cardiology, Ústí nad Labem, Czech Republic
bUniversity Hospital in Hradec Králové, 1st Department of Internal Medicine, Hradec Králové, Czech Republic
cInstitute Dante Passaneese of Cardiology, Sao Paulo, Brasil
dCzech Academy of Science, Institute of Nuclear Physics, Řež, Czech Republic
eUniversity Hospital in Motol, Prague, Czech Republic
fUniversity Hospital in Hradec Králové, 2nd Department of Internal Medicine, Hradec Králové, Czech Republic

Received September 1, 2003
Accepted January 1, 2004

The aim of this study was to evaluate the incidence and the cause of “edge restenosis” after implantation of high activity 41.1 μCi±1.2 μCi=1520 kBq±44 kBq, β-emitting (55Co) stents. Proton bombarding in cyclotron has brought the radioactivity. Intravascular ultrasound (IVUS) investigation has been completed in 10 patients. The angiographies performed at 6 month revealed restenosis >50 % in 5 cases (50 %). The analysis of edges (5 mm distally and proximally to the last stent struts) showed no significant changes in TVV (187.3±62.60 mm3 and 176.9±53.5 mm3) but PMV increase significantly (i.e. neointimal proliferation) from 61.9±31.2 mm3 to 82.2±43.4 mm3 (p<0.04) and was the major contributor (from 66 %) to lumen volume loss (125.4±40.7 mm3 and 94.7±22.2 mm3, p<0.02). In conclusion, neither statistically significant positive nor negative remodelling at the “stent edges“, were present. Statistically significant increase in plaque+media volume (i.e. neointimal hyperplasia) and reduction in lumen volume were found. The cause of “edge restenosis” was especially (from 66 %) due to increase in plaque+media volume (i.e. neointimal hyperplasia). Probably, main reason for “edge effect”/neointimal hyperplasia was in this trial sharp fall-off in radiation at the edges of the stents.

Funding

This study was supported by a grant from IGA Ministry of health Czech Republic, number NA 4786-3/98.

References

22 live references

Open full article