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Titolo:
Intravascular radiation for the prevention of recurrence of restenosis in coronary arteries
Autore:
Gruberg, L; Waksman, R;
Indirizzi:
Washington Hosp Ctr, Inst Cardiovasc Res, Cardiac Catheterizat Lab, Washington, DC 20010 USA Washington Hosp Ctr Washington DC USA 20010 Lab, Washington, DC 20010 USA
Titolo Testata:
EXPERT OPINION ON INVESTIGATIONAL DRUGS
fascicolo: 5, volume: 10, anno: 2001,
pagine: 891 - 907
SICI:
1354-3784(200105)10:5<891:IRFTPO>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
IN-STENT RESTENOSIS; CATHETER-BASED RADIOTHERAPY; INTRACORONARY RADIATION; BALLOON ANGIOPLASTY; BETA-RADIATION; INHIBITS RECURRENCE; FOLLOW-UP; THERAPY; IRRADIATION; DISEASE;
Keywords:
angioplasty; brachytherapy; neointima; stent;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
54
Recensione:
Indirizzi per estratti:
Indirizzo: Gruberg, L Washington Hosp Ctr, Inst Cardiovasc Res, Cardiac Catheterizat Lab, 110 Irving St NW,Suite 4B-1, Washington, DC 20010 USA Washington Hosp Ctr 110 Irving St NW,Suite 4B-1 Washington DC USA 20010
Citazione:
L. Gruberg e R. Waksman, "Intravascular radiation for the prevention of recurrence of restenosis in coronary arteries", EXPERT OP I, 10(5), 2001, pp. 891-907

Abstract

Despite the use of new technology and adjunctive pharmacological therapy, in-stent restenosis continues to hamper the outcome of approximately 150,000 patients who undergo stented coronary angioplasty; in the US annually While coronary stenting eliminates elastic recoil and vessel contracture by acting as a mechanical scaffold within the vessel, it is unable to inhibit excessive neointimal formation and may actually promote it. Fur years, the growth-inhibiting properties of ionising radiation have been used successfully to control benign proliferative disorders. Based on this experience, vascular brachytherapy. the intravascular delivery: of radiation, was viewed asa viable solution to inhibit neointimal hyperplasia. A series of studies performed in animal models identified the mechanisms by which radiation may reduce restenosis. Data from these studies showed that endovascular radiation reduces restenosis by inhibiting cell proliferation and hy inducing favourable remodelling. The success of these initial studies led to several double-blind. multicentre, placebo-controlled, randomised, clinical trials evaluating intravascular radiation, with either gamma- or beta -radiation sources, proved to be an effective solution for tile prevention of neointimal proliferation and restenosis. However. an increased rate of late thrombosis in patients who had received intracoronary radiation did evolve from the initial use of this therapy. Prolonged antiplatelet therapy and a reduction in the number of new stents placed at the time of radiation has been shown to minimise these complications. Other concerns that still need to be resolved include edge effect and geographical miss, Intravascular brachytherapy is currently the only approved therapy for this complex disease. It is clearthat there are still on-going concerns that will eventually be clarified when the long-term results hom ongoing clinical trials around the world become available.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 14:10:38