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The black hole: echolucent tissue observed following intracoronary radiation.
- Source :
-
International journal of cardiovascular interventions [Int J Cardiovasc Intervent] 2003; Vol. 5 (3), pp. 137-42. - Publication Year :
- 2003
-
Abstract
- Aims: Recent trials in humans have given us insight into some of the consequences of intracoronary radiation. The authors describe a new observation noted on intravascular ultrasound: that of intraluminal echolucent tissue, dubbed the 'black hole', noted at six-month follow-up.<br />Methods and Results: One hundred and twenty-eight consecutive patients enrolled in brachytherapy protocols were analyzed. The control group (C) consisted of individuals who underwent percutaneous transluminal coronary angioplasty with (n = 48) and without (n = 22) stent implantation. Radiation groups included those who underwent low activity (LA) (n = 18), high activity (HA) (n = 26) and cold-end (CE) (n = 18) radioactive stenting. The Novoste Betacath (n = 39) and Guidant (n = 27) catheter-based radiation systems were also employed. At six-month follow-up echolucent tissue was identified in a total of 28 cases (22%). Angiographic restenosis occurred in 17 cases (61%). No echolucent tissue was seen in the control group or in the LA group. HA and CE radioactive stents were most commonly associated with echolucent tissue. Echolucent tissue was seen in all groups treated with catheter-based radiation with and without stenting. Pathology after atherectomy demonstrated smooth muscle cells scattered in extracellular matrix containing abundant proteoglycans and an absence of elastin and mature collagen.<br />Conclusions: Echolucent tissue is common after radioactive stenting. It is composed of tissue rich in proteoglycans while poor in mature collagen and elastin.
- Subjects :
- Coronary Stenosis pathology
Coronary Vessels pathology
Endothelium, Vascular pathology
Follow-Up Studies
Graft Occlusion, Vascular pathology
Humans
Time Factors
Angioplasty, Balloon, Coronary adverse effects
Blood Vessel Prosthesis Implantation adverse effects
Brachytherapy adverse effects
Coronary Stenosis diagnostic imaging
Coronary Stenosis therapy
Coronary Vessels diagnostic imaging
Coronary Vessels radiation effects
Endothelium, Vascular diagnostic imaging
Endothelium, Vascular radiation effects
Graft Occlusion, Vascular diagnostic imaging
Graft Occlusion, Vascular etiology
Postoperative Complications
Stents adverse effects
Ultrasonography, Interventional
Subjects
Details
- Language :
- English
- ISSN :
- 1462-8848
- Volume :
- 5
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International journal of cardiovascular interventions
- Publication Type :
- Academic Journal
- Accession number :
- 12959730
- Full Text :
- https://doi.org/10.1080/14628840310007673