Stroke, Vol 25, 424-428, Copyright © 1994 by American Heart Association
S Shimotakahara and MR Mayberg
BACKGROUND AND PURPOSE: Restenosis complicates a significant proportion of
endovascular and open vascular procedures such as carotid endarterectomy.
In contrast to the primary atheroma, restenosis is characterized by intimal
hyperplasia of vascular smooth muscle cells. We hypothesized that gamma
radiation would reduce restenosis by limiting intimal hyperplasia after
arterial injury. METHODS: To demonstrate the effect of gamma radiation on
smooth muscle hyperplasia in vivo, a standardized bilateral carotid balloon
catheter arterial injury was produced in 37 rats. A single dose of 750,
1500, or 2250 cGy (1cGy = 1 rad) gamma radiation was delivered to the right
carotid artery at either 1 or 2 days after injury; the shielded
contralateral carotid artery served as matched control. At 21 days after
injury, vessels were perfusion-fixed in situ, and cross-sectional area of
neointima was determined from axial sections using image analysis. RESULTS:
Marked reductions in neointimal cross-sectional area were demonstrated in
vessels subjected to 1500- and 2250-cGy radiation at both 1 and 2 days
after injury. A less prominent effect was noted for 750 cGy, reaching
statistical significance only at 2 days after injury. By two-way ANOVA,
radiation dose (P = .0002), timing of radiation delivery (P = .003), and an
interaction between timing and dose (P = .0278) were significantly
associated with reduction in neointimal cross- sectional area. At 1500 cGy,
delivery of radiation 1 day after injury inhibited neointimal hyperplasia
more prominently than the same dose 2 days after injury; a dose-response
relation was evident at 1 day. CONCLUSIONS: Radiation may be an important
adjunctive therapy for reducing the incidence of restenosis after
angioplasty or endarterectomy.
ARTICLES
Gamma irradiation inhibits neointimal hyperplasia in rats after arterial injury
Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle 98195.
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