Radioactive 133-xenon gas-filled balloon to prevent restenosis - Dosimetry, efficacy, and safety considerations

Article

关键词: INHIBITS NEOINTIMA FORMATION;    RADIATION-THERAPY;    INTRACORONARY IRRADIATION;    BETA-RADIATION;    ANGIOPLASTY;    CATHETER;    ARTERIES;    XE-133;    INJURY;    SWINE;   

DOI  :  10.1161/01.CIR.0000023945.21317.27

来源: SCIE

【 摘 要 】

Background-Ionizing radiation administered intraluminally via catheter-based systems using solid beta and gamma sources or liquid-filled balloons has shown reduction in the neointima formation after injury in the porcine model. We propose a novel system that uses a 133-Xenon (Xe-133) radioactive gas-filled balloon catheter system. Methods and Results-Overstretch balloon injury was performed in the coronary arteries of 33 domestic pigs. A novel Xe-133 radioactive gas-filled balloon (3.5/45 mm) was positioned to overlap the injured segment with margins. After vacuum was obtained in the balloon catheter, approximate to2.5 cc of Xe-133 gas was injected to fill the balloon. Doses of 0, 7.5, 15, and 30 Gy were delivered to a distance of 0.25 mm from the balloon surface. The dwell time ranged from 1.0 to 4.0 minutes, depending on the dose. Localization of Xe-133 in the balloon was verified by a gamma camera. The average activity in a 3.5/45-mm balloon was measured at 67.7+/-12.1 mCi, and the total diffusion loss of the injected dose was 0.26% per minute of the injected dose. Bedside radiation exposure measured between 2 and 6 mR/h, and the shallow dose equivalent was calculated as 0.037 mrem per treatment. Histomorphometric analysis at 2 weeks showed inhibition of the intimal area (intimal area corrected for medial fracture length [IA/FL]) in the irradiated segments of 0.26 +/- 0.08 with 30 Gy, 0.07+/-0.24 with 15 Gy, and 0.12+/-0.89 with 7.5 Gy versus 0.76+/-0.08 with control P<0.001. Conclusions-Xe-133 gas-filled balloon is feasible and effective in the reduction of neointima formation in the porcine model and safe for use in coronary arteries.

【 授权许可】

Free