AI Article Synopsis
- This study investigates how intracoronary radiation (IR) impacts vascular remodeling after balloon angioplasty in pig coronary arteries, focusing on preventing restenosis, a condition where arteries narrow again after treatment.
- It involved 20 juvenile swine, evaluating changes in arterial components following treatment with either beta- or gamma-radiation after balloon injury.
- Results showed that IR significantly reduced certain areas related to neointimal growth, but resulted in increased remodeling in disrupted regions of the arteries compared to untreated controls.
Article Abstract
Background: Restenosis is a consequence of both neointimal hyperplasia and vessel remodeling. Prior studies have shown that intracoronary radiation (IR) prevents neointima accumulation, but its contribution to vessel remodeling is unknown. The purpose of this study was to evaluate the effect of IR on differential vascular remodeling after balloon angioplasty in porcine coronary arteries.
Methods: A total of 20 juvenile swine (30 coronary arteries) were subjected to overstretch balloon injury (BI) followed by IR with either beta- or gamma-radiation ((90)Y or (192)Ir). After 2 weeks following treatment, serial tissue sections were perfusion fixed and stained by hematoxylin and eosin (H&E), Verhoeff von Giesson (VVG), or Masson Trichrome. Adventitial area (AA), lumen area (LA), vessel area (VA), intimal area (IA), and IA corrected for medial fracture length (IA/FL) were quantified by digital image analysis. The vessel circumference was divided into two regions containing (1) the undisrupted region (UReg) with the undisrupted arc of media and internal elastic lamina (IEL) and (2) the disrupted region (DReg) with the disrupted arc between the medial tears. Quantitative regional analysis was performed by (1) measuring the IEL to define the UReg, (2) calculating the area of the UReg with the perimeter value derived from measurement of the IEL, and (3) calculating the DReg as follows: LA+IA-UReg. Immunohistochemical smooth muscle cell alpha-actin and Masson Trichrome were quantified by digital image analysis.
Results: The IA/FL was significantly smaller following treatment with (90)Y or (192)Ir vs. control (P<.01). A smaller AA was obtained following IR with both beta- and gamma-sources vs. control (P<.01). The UReg calculation was smaller in the irradiated arteries as compared to control (beta: 2.3+/-0.4 mm(2), gamma: 2.1+/-0.5 mm(2), P<.01 vs. control; control: 3.6+/-0.7 mm(2)). In contrast, the DReg was increased following IR, as demonstrated by the FL and the calculated area of the injured segment (control: 2.7+/-0.5 mm(2); beta: 5.5+/-1.1 mm(2), gamma: 5.5+/-1.1 mm(2), P<.01 vs. control). Adventitial alpha-actin positive cell density (CD) was decreased after IR; however, the collagen density was similar. In contrast, the neointimal collagen density in the injured segment was significantly decreased following IR.
Conclusion: We consider that the global arterial remodeling after IR is a heterogeneous process that includes the absence of retraction in an UReg and a positive remodeling in the DReg as shown in the porcine coronary model. These changes in adventitia and neointima appear to contribute to differential vascular remodeling caused by IR in injured vessels.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/s1522-1865(00)00078-0 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Drug-Coated Balloons for the Treatment of Coronary Artery Disease: A Review.
JAMA Cardiol
December 2024
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
Importance: Drug-coated balloon (DCB) angioplasty has emerged as an alternative to drug-eluting stent (DES) implantation for percutaneous coronary intervention (PCI) in patients with coronary in-stent restenosis (ISR) as well as de novo coronary artery disease.
Observations: DCBs are balloons coated with antiproliferative agents and excipients, whose aim is to foster favorable vessel healing after appropriate lesion preparation. By providing homogeneous antiproliferative drug delivery in the absence of permanent foreign body implantation, DCBs offer multiple advantages over DES, including preservation of vessel anatomy and function and positive vessel remodeling.
Predictors and long-term prognostic significance of bailout stenting during percutaneous coronary interventions with sirolimus-coated balloon: a subanalysis of the EASTBOURNE study.
Am J Cardiol
December 2024
DCB Academy, Milano, Italy; Fondazione Ricerca e Innovazione Cardiovascolare, Milano, Italy; University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA. Electronic address:
Percutaneous coronary intervention (PCI) with drug-coated balloon (DCB) has been expanding progressively in recent years. Convincing evidence demonstrated the ability of some DCB to promote positive vessel remodeling with potential clinical benefits at follow-up. When PCI with DCB results in suboptimal angiographic results (residual stenosis >30% or type C-F dissection), bailout stenting (BS) implantation is recommended to mitigate the risk of abrupt vessel occlusion or restenosis.
View Article and Find Full Text PDFStaged, hybrid approach by zone 2 arch replacement and completion thoracic endoprosthesis in retrograde acute type A aortic dissection.
J Vasc Surg Cases Innov Tech
February 2025
Department of Cardio-Thoracic Surgery, Radboud Umc, Nijmegen, The Netherlands.
We describe a case of retrograde acute type A aortic dissection approached by a hybrid, staged approach consisting of a zone 2 arch replacement and completion thoracic endovascular aortic repair procedure combined with distal balloon-assisted stent graft dilatation to prevent retrograde false lumen flow. This technique may be an alternative and more complete when compared with a frozen elephant trunk procedure at onset. Additionally, favorable remodeling of the entire thoracic aorta is observed.
View Article and Find Full Text PDFPF-477736 modulates vascular smooth muscle cells phenotypic transition through Chk1/p53/CD44 pathway.
Tissue Cell
December 2024
Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China. Electronic address:
Introduction: The phenotypic transition of vascular smooth muscle cells (VSMCs) from a quiescent, contractile type to a secretory phenotype with high proliferation and mobility is a key event in vascular remodeling. PF-477736 is an ATP-competitive inhibitor of Chk1 which induces the accumulation of DNA damage by increasing the level of replicative stress, and ultimately inhibiting cell proliferation or causing cell death. Although this compound has been utilized as an anti-tumor drug, its role in vascular remodeling remains unclear.
View Article and Find Full Text PDFPulmonary Impedance and Wave Reflections in Adults with Mitral Stenosis: Immediate and Follow-Up Effects of Balloon Valvuloplasty.
Ann Biomed Eng
December 2024
Department of Biomedical Engineering, Washington University, St. Louis, MO, USA.
Purpose: We compared adults with mitral stenosis (MS) to 8 controls (CONT) to see how pulmonary impedance and wave reflections differ at baseline and after balloon valvuloplasty.
Methods: We separated the MS patients into groups according to mean pulmonary artery pressure: moderate (MOD; ≤ 26 mmHg, n = 21) and high (HIGH; > 26 mmHg, n = 33). We made baseline high-fidelity measurements in all patients, in the MS groups after vasodilation with nitroprusside, immediately and 4 months after balloon valvuloplasty.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!