Review
Early and late effects of radiation treatment for prevention of coronary restenosis: a critical appraisal
O F Bertranda, S Lehnertb, R Mongraina, M G Bourassaa
a Research Centre,
Montreal Heart Institute, Belanger 5000, Montréal, Québec H1T 1C8,
Canada, b Divisions of Experimental Medicine and Radiation
Oncology, McGill University, Québec, Canada
Correspondence to: Dr Bertrand. email: ofbert@icm.umontreal.ca
Accepted for publication 17 June 1999
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Radiation treatment represents a new and promising approach for prevention of restenosis after coronary intervention.1 2 Restenosis results from a complex interplay between thrombosis, vessel remodeling, and neointima formation. Although the exact contribution of each process is still debated, neointima formation has been shown to play a major role in humans after balloon angioplasty and more recently after stent implantation. It is now admitted that vessel shrinkage plays a predominant role in restenosis after catheter based coronary interventions, whereas in-stent restenosis seems exclusively caused by neointima formation.3 4 Neointima formation results mainly from the accumulation of proliferating smooth muscle cells (SMCs) and extracellular matrix (ECM) secretion. Adventitial myofibroblast proliferation and ECM deposition may also play a role in vessel shrinkage in a way similar to scar retraction after skin injury.5
Radiation treatment holds the promise to reduce or prevent SMC and
myofibroblast proliferation and thus to interfere with vessel
remodeling and neointima
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