^(103)Pd支架预防兔髂动脉支架后再狭窄的实验研究

Experimental study of the preventive effect of^(103)Pd stent on in-stent restenosis in rabbit iliac artery

目的 探讨^(103)Pd支架置入对兔髂动脉支架后再狭窄的预防作用。方法 20只新西兰大白兔按支架放射性活度分为6组[2.22(n=3),5.55(n=4),9.25(n=4),14.8(n=3),22.2(n=3),33.3 MBq(n=3)],于每只动物一侧髂动脉内置入不同活度的^(103)Pd支架,对侧髂动脉内置入非放射性支架作对照。高脂饲养28d后进行髂动脉血管造影和定量组织病理学分析,观察治疗效果。结果组织病理学定量分析示不同剂量^(103)Pd支架组新生内膜面积和狭窄百分比均明显低于对照组,但其效应不呈明显剂量依赖性。结论 ^(103)Pd支架能明显抑制支架置入后兔髂动脉新生内膜增生和支架后再狭窄的发生。

Objective To investigate the ability of γ-emitting 103Pd radioactive stent implantation for preventing in-stent restenosis in iliac artery of rabbits. Methods Twenty New Zealand white rabbits were divided into six groups on the basis of radioactivity loading [2.22 (n = 3), 5.55 (n = 4), 9.25 (n = 4), 14.8 (n = 3), 22.2 (n = 30), 33.3 MBq (n = 3)].103Pd stent was implanted in one of the two iliac arteries of each rabbit and nonradioactive stent in the contralateral artery. The rabbits were fed with high fat diet. Treatment efficiency was assessed by angiography and quantitative histomorphometry of the stented iliac segments 28 d after the implantation. Results Quantitative histomorphometry analysis indicated that103 Pd stents induced a significant reduction in neointimal area and the percentage of stenosis within radioactive stents was lower compared with that in the control stents. Nevertheless, the suppression of neointima formation by103 Pd stent implantation was not in a dose-dependent manner. Conclusions Low-dose intravascular brachytherapy via a γ-particle-emitting 103 Pd radioactive stent potently inhibits neointimal hyperplasia and prevents the in-stent restenosis in rabbit iliac artery.103 Pd stent implantation probably can be employed as a novel means to prevent in-stent restenosis.