Jumat, 13 Januari 2012

Adjunct brachytherapy: a new concept to prevent intimal hyperplasia after surgical endarterectomy?

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Objective: Endarterectomy represents a therapeutical option for patients with advanced coronary artery disease. The mid-term results are compromised by restenosis due to neointima formation. The aim of this study was to evaluate a new treatment concept – endarterectomy with consecutive gamma-irradiation – in a rat model. Methods: Male Sprague–Dawley rats underwent left carotid endarterectomy with removal
of intima: control (n = 10) or were irradiated with 15 Gray (Gy) (n = 13) or 20 Gy (n = 10) postoperatively and compared with sham-operated rats (n = 10). After 3 weeks, carotid arteries were perfusion-fixed and vessel compartment areas were measured. Transmission electron microscopy and immunohistochemical staining were used to confirm neointima formation. Results: Three weeks after endarterectomy, neointimal hyperplasia was found in the control group (0.07 ± 0.04 mm2). After irradiation, a dose-dependent reduction of neointima was observed (0.003 mm2 at 15 Gy and 0.0007 mm2 at 20 Gy, P)

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