冠状动脉内^(32)P放射治疗对预防支架后再狭窄的作用

Effects of intracoronary ^(32)P irradiative therapy on restenosis after coronary angioplasty

目的 观察冠状动脉内 3 2 P放射治疗对预防冠状动脉支架术后假性内膜增生和再狭窄的作用。方法 对成功进行冠状动脉内支架成形术的 3 0例患者 ,将不同剂量的 3 2 P放射源经 5F管推送入冠状动脉支架术部位。在放射治疗前、结束时和随访 6个月后分别进行定量冠状动脉造影和血管内超声检查。结果 定量冠状动脉造影显示 ,3 0例支架成形术全部成功。全组平均后期管腔缩减径为 (-0 0 3± 0 5 3 )mm ,缩减指数为 -0 0 9± 0 5 1。血管内超声显示 ,放射治疗结束时和随访 6个月后平均内腔面积分别为 (5 5 2± 1 86)mm2 和 (5 61± 1 5 3 )mm2 ,两者差异无显著性 (P >0 0 5 ) ;外弹力膜腔面积分别为 (14 11± 3 86)mm2 和 (14 3 7± 2 44 )mm2 ,两者差异无显著性 (P >0 0 5 )。结论 冠状动脉内 3 2 P放射治疗能有效预防支架术后冠状动脉内膜假性增生和再狭窄。

Objective To study the effects of inhibiting neointima formation and restenosis of coronary with intracoronary 32 P irradiative therapy after coronary angioplasty. Methods 32 P source train was delivered to native coronary arteries through a 5F catheter after successful brachytherapy in 30 patients. Quantitative coronary angiography and intravascular ultrasound(IVUS) were performed before operation, during the initial procedure and at 6-month of follow-up. Results Quantitative coronary angiography showed no restenosis was present in 30 patients. Angiographic late loss was (-0 03±0 53)mm, with a -0 09±0 51 loss index. IVUS demonstrated no significant reduction in minimal lumen area 〔from (5 52±1 86)mm 2 after treatment to (5 61±1 53)mm 2 at follow-up〕, with no significant change in external elastic membrane area 〔(14 11±3 86)mm 2 to (14 37±2 44)mm 2〕 over the 6-month follow-up. Conclusion 32 P irradiative therapy can effectively inhibit neointima formation and prevent coronary restenosis after coronary angioplasty.