Sustained attenuation of neointimal coverage over the stent following brachytherapy for in-stent restenosis: angioscopic findings

Circ J. 2006 Jul;70(7):846-50. doi: 10.1253/circj.70.846.

Abstract

Background: The nature of the vessel lumen following vascular brachytherapy (VBT) has not been extensively explored in the clinical setting.

Methods and results: By using angioscopy, 33 stents treated with percutaneous balloon angioplasty with or without VBT for in-stent restenosis after 8.9 +/- 2.1 months of the treatment were followed (VBT =14 lesions; control =19 lesions). Neointimal coverage, stent attachment, and the presence of red or white thrombi were factors that were assessed. The majority of the stents (74%) were fully covered with non-transparent neointima in the control group. In contrast, stent struts were clearly seen in 57% lesions with VBT. The absence of neointima with glittering stent struts were only seen in 29% of lesions in VBT (p = 0.03). Incomplete stent attachment was not detected in the controls, whereas 14% were in VBT (p = 0.17). Red thrombi were observed in 14% with VBT and in 16% in controls, which showed that there was a similar incidence regardless of the treatment. Neither exposure of stent struts (p = 0.5) nor incomplete stent attachment (p = 1.0) was related to thrombi.

Conclusions: The exposure of stent struts and incomplete stent attachment were occasionally observed by angioscopy even 9 months after VBT for the treatment of in-stent restenosis.

MeSH terms

  • Aged
  • Angina Pectoris / therapy*
  • Angioplasty, Balloon, Coronary*
  • Angioscopy
  • Brachytherapy
  • Coronary Restenosis / etiology
  • Coronary Restenosis / pathology
  • Coronary Restenosis / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Stents*
  • Tunica Intima* / pathology