Effect of external beam irradiation on neointimal hyperplasia after experimental coronary artery injury
Human coronary artery restenosis after percutaneous revascularization is a response to mechanical injury. Smooth muscle cell proliferation is a major component of restenosis, resulting in obstructive neointimal hyperplasia. Because ionizing radiation inhibits cellular proliferation, this study teste...
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Published in | Journal of the American College of Cardiology Vol. 19; no. 5; pp. 1106 - 1113 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York, NY
Elsevier Inc
01.04.1992
Elsevier Science |
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Abstract | Human coronary artery restenosis after percutaneous revascularization is a response to mechanical injury. Smooth muscle cell proliferation is a major component of restenosis, resulting in obstructive neointimal hyperplasia. Because ionizing radiation inhibits cellular proliferation, this study tested in a porcine coronary injury model the hypothesis that the hyperplastic response to coronary artery injury would be attenuated by X-irradiation.
Deep arterial injury was produced in 37 porcine left anterior descending coronary artery segments with overexpanded, percutaneously delivered tantalum wire coils. Three groups of pigs were irradiated with 300-kV X-rays after coil injury: Group I (n = 10), 400 cGy at 1 day; Group II (n = 10), 400 cGy at 1 day and 400 cGy at 4 days and Group III (n = 9), 800 cGy at 1 day. Eight pigs in the control group underwent identical injury but received no radiation. Treatment efficacy was histologically assessed by measuring neointimal thickness and percent area stenosis.
Mean neointimal thickness in all irradiated groups was significantly higher than in the control groups and thickness was proportional to X-ray dose.
X-irradiation delivered at these doses and times did not inhibit proliferative neointima. Rather, it accentuated the neointimal response to acute arterial injury and may have potentiated that injury. |
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AbstractList | Human coronary artery restenosis after percutaneous revascularization is a response to mechanical injury. Smooth muscle cell proliferation is a major component of restenosis, resulting in obstructive neointimal hyperplasia. Because ionizing radiation inhibits cellular proliferation, this study tested in a porcine coronary injury model the hypothesis that the hyperplastic response to coronary artery injury would be attenuated by X-irradiation. Deep arterial injury was produced in 37 porcine left anterior descending coronary artery segments with overexpanded, percutaneously delivered tantalum wire coils. Three groups of pigs were irradiated with 300-kV X-rays after coil injury: Group I (n = 10), 400 cGy at 1 day; Group II (n = 10), 400 cGy at 1 day and 400 cGy at 4 days and Group III (n = 9), 800 cGy at 1 day. Eight pigs in the control group underwent identical injury but received no radiation. Treatment efficacy was histologically assessed by measuring neointimal thickness and percent area stenosis. Mean neointimal thickness in all irradiated groups was significantly higher than in the control groups and thickness was proportional to X-ray dose. X-irradiation delivered at these doses and times did not inhibit proliferative neointima. Rather, it accentuated the neointimal response to acute arterial injury and may have potentiated that injury. Human coronary artery restenosis after percutaneous revascularization is a response to mechanical injury. Smooth muscle cell proliferation is a major component of restenosis, resulting in obstructive neointimal hyperplasia. Because ionizing radiation inhibits cellular proliferation, this study tested in a porcine coronary injury model the hypothesis that the hyperplastic response to coronary artery injury would be attenuated by X-irradiation. Deep arterial injury was produced in 37 porcine left anterior descending coronary artery segments with overexpanded, percutaneously delivered tantalum wire coils. Three groups of pigs were irradiated with 300-kV X-rays after coil injury: Group I (n = 10), 400 cGy at 1 day; Group II (n = 10), 400 cGy at 1 day and 400 cGy at 4 days and Group III (n = 9), 800 cGy at 1 day. Eight pigs in the control group underwent identical injury but received no radiation. Treatment efficacy was histologically assessed by measuring neointimal thickness and percent area stenosis. Mean neointimal thickness in all irradiated groups was significantly higher than in the control groups and thickness was proportional to X-ray dose. X-irradiation delivered at these doses and times did not inhibit proliferative neointima. Rather, it accentuated the neointimal response to acute arterial injury and may have potentiated that injury. |
Author | Koval, Thomas M. Edwards, William D. Browne, Kevin Vlietstra, Ronald E. Holmes, David R. Schwartz, Robert S. Bailey, Kent R. Camrud, Allan R. |
Author_xml | – sequence: 1 givenname: Robert S. surname: Schwartz fullname: Schwartz, Robert S. organization: From the Divisions of Cardiovascular Diseases and Internal Medicine, Radiation Oncology and Section of Medical Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA – sequence: 2 givenname: Thomas M. surname: Koval fullname: Koval, Thomas M. organization: From the Divisions of Cardiovascular Diseases and Internal Medicine, Radiation Oncology and Section of Medical Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA – sequence: 3 givenname: William D. surname: Edwards fullname: Edwards, William D. organization: From the Divisions of Cardiovascular Diseases and Internal Medicine, Radiation Oncology and Section of Medical Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA – sequence: 4 givenname: Allan R. surname: Camrud fullname: Camrud, Allan R. organization: From the Divisions of Cardiovascular Diseases and Internal Medicine, Radiation Oncology and Section of Medical Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA – sequence: 5 givenname: Kent R. surname: Bailey fullname: Bailey, Kent R. organization: From the Divisions of Cardiovascular Diseases and Internal Medicine, Radiation Oncology and Section of Medical Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA – sequence: 6 givenname: Kevin surname: Browne fullname: Browne, Kevin organization: From the Divisions of Cardiovascular Diseases and Internal Medicine, Radiation Oncology and Section of Medical Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA – sequence: 7 givenname: Ronald E. surname: Vlietstra fullname: Vlietstra, Ronald E. organization: From the Divisions of Cardiovascular Diseases and Internal Medicine, Radiation Oncology and Section of Medical Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA – sequence: 8 givenname: David R. surname: Holmes fullname: Holmes, David R. organization: From the Divisions of Cardiovascular Diseases and Internal Medicine, Radiation Oncology and Section of Medical Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA |
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Keywords | Animal model Coronary artery Instrumentation therapy Cardiovascular disease Instrumental dilatation X ray irradiation Pig Prevention Restenosis Vertebrata Mammalia Animal Complication Artiodactyla Ungulata |
Language | English |
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artery lesions publication-title: J Atheroscler Res doi: 10.1016/S0368-1319(64)80043-0 contributor: fullname: Amronin – volume: 60 start-page: 39 year: 1976 ident: 10.1016/0735-1097(92)90303-5_BIB23 article-title: Coronary heart disease after mediastinal irradiation for Hodgkin's disease publication-title: Am J Med doi: 10.1016/0002-9343(76)90531-3 contributor: fullname: McReynolds – volume: 17 start-page: 307 year: 1972 ident: 10.1016/0735-1097(92)90303-5_BIB13 article-title: Permeability of arterial internal elastic laminae in irradiated mice publication-title: Exp Mol Pathol doi: 10.1016/0014-4800(72)90043-3 contributor: fullname: Hampton |
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Snippet | Human coronary artery restenosis after percutaneous revascularization is a response to mechanical injury. Smooth muscle cell proliferation is a major component... |
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SubjectTerms | Angioplasty, Balloon, Coronary Animals Biological and medical sciences Cell Division - radiation effects Coronary Disease - prevention & control Coronary Disease - radiotherapy Coronary Vessels - injuries Coronary Vessels - pathology Coronary Vessels - radiation effects Diseases of the cardiovascular system Dose-Response Relationship, Radiation Endothelium, Vascular - physiopathology Endothelium, Vascular - radiation effects Hyperplasia - prevention & control Hyperplasia - radiotherapy Linear Models Medical sciences Postoperative Complications - prevention & control Postoperative Complications - radiotherapy Radiotherapy - methods Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Recurrence Swine Treatment Outcome Wounds and Injuries - radiotherapy |
Title | Effect of external beam irradiation on neointimal hyperplasia after experimental coronary artery injury |
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