^(188)Re灌注球囊照射预防兔血管再狭窄

Intravascular β-irradiation with a liquid ~ ( 188)Re-filled balloon for the prevention of restenosis in rabbit model

目的 观察188Re灌注球囊血管内照射对兔血管损伤后再狭窄的预防作用。方法 应用球囊过度扩张损伤兔双侧髂动脉 ,随机选择一侧髂动脉进行188Re灌注球囊血管内局部照射 ,对受照射血管进行血管造影、组织病理学检查及增殖细胞核抗原 (PCNA)染色分析。结果 与非照射组血管比较 ,照射组血管直径较大 [( 1 .94± 0 .1 9)vs ( 1 .77± 0 .2 8)mm ,P <0 .0 5],新生内膜面积减少[( 1 .1 2± 0 .75)vs ( 2 .1 7± 1 .2 1 )mm2 ,P <0 .0 1 ],狭窄面积百分比降低 [( 1 9.2 3± 1 2 .6 0 ) %vs ( 34.4 5±1 7.4 9) % ,P <0 .0 1 ],PCNA阳性率低 [( 3.75± 2 .0 9) %vs ( 5.6 4± 1 .74 ) % ,P <0 .0 5]。 0 .5mm深处组织吸收剂量为 1 5Gy。结论 188Re灌注球囊血管内照射能够抑制兔损伤血管再狭窄。

Objective To investigate the effects of intravascular β-irradiation with a liquid ~ 188Re-filled balloon on restenosis in rabbit model, and to evaluate the feasibility of the intravascular irradiation. Methods The bilateral iliac arteries of 14 rabbits were injured by catheter balloon overdilation. A random side iliac artery of the rabbit was irradiated by a liquid ~ 188Re-filled balloon with the radioactivity of 15 Gy at a depth of 0.5 mm beneath the skin close to the artery, and the other iliac artery served as a control. At 12 weeks after operation, quantitative angiography, histopathology and immunohistochemistry analysis were performed in the injured iliac arteries to evaluate the effects of irradiation. Results There was significant increase in iliac artery diameter [(1.94±0.19) vs (1.77±0.28) mm,P<0.05)], and significant decrease in neointimal area [(1.12±0.75) vs (2.17±1.21) mm^2,P<0.01], percent stenosis area [(19.23±12.60)% vs (34.45±17.49)%,P<0 01], and the proliferative cell nuclear antigen (PCNA) positive rate of vascular smooth muscle cells [(3.75±2.09)% vs (5.64±1.74)%,P<0.05] in ~ 188Re-filled balloon irradiation group compared with control group. Conclusions Intravascular β-irradiation by a liquid ~ 188Re-filled balloon with 15 Gy at 0.5 mm tissue depth beneath the skin close to the artery in rabbit model could inhibit neointimal proliferation and prevent restenosis. The intravascular brachytherapy with irradiation for prevention of restenosis is technically feasible.