Volume 25 Issue 1
Feb.  2001
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Citation:

The problem of the “candy wrapper” for β-particle emitting stent implantation

  • Received Date: 2000-08-16
  • There is an "edge effect" or "candy wrapper" problem at the stent edges for β-particle emitting stent im-plantation. The mechanism for "candy wrapper" may conclude low activity level of radiation, aggressive injury to vessel at the margins of the stent and neointimal proliferation due to low-dose radiation stimulation. The methods to solve the "candy wraper" could be proposed:(1) the square-shouldered balloon, (2) the cold-end stent, (3) the hot-end stent, (4) a self-expanding radioactive stent, (5) theγ-stent and so on.
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  • [1] Albiero R,Adamian M,Kobayashi N,et al.Short-and intermediate-term resuults of 32P radioactive β-emitting stent implantation in patients with coronary artery disease:The Milan dose-response study[J].Circulation,2000,101:18-26.
    [2] Moses JW,Ellis SG,Bailey SR,et al.Short-term (1 month) results of the dose response IRIS feasibility study of a beta-particle emitting radioisotope stent[J].J Am Coll Cardiol,1998,31:350 A.
    [3] Hoffmann R,Mintz GS,Dussaillant GR,et al.Pat-terns and mechanism of in-stent restenosis:a serial in-travascular ultrasound study[J].Circulation,1996,94:1247-1254.
    [4] Hehrlein C,Stintz M,Kinscherf R,et al.β-particle-emitting stents in a porcine coronary restenosis model:a dose-response study[J].Circulation,1996,94:2364-2368.
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    [6] Carter AJ,Laird JR,Bailey LR,et al.Effects of en-dovascular irradiation from a β-particle-emitting stent in a porcine coronary restenosis model:a dose-re-sponse study[J].Circulation,1996,94:2364-2368.
    [7] Farb A,Sangiorgi G,Carter AJ,et al.Pathology of acute and chronic coronary stenting in humans[J].Circulation,1999,99:44-52.
    [8] Weinberger J,Amols H,Ennis RD,et al.Intracoro-nary irradiation:dose response for the prevention of restenosis in swine[J].Int J Radiat Oncol Biol Phys,1996,36:767-775.
    [9] Carter AJ,Scott D,Bailey LR,et al.High activity 32P stents promote development of atherosclerosis at six months in a porcine model[J].Circulation,1997,96(suppl I):I-607.
    [10] Laird JR,Carter AJ,Kufs WM,et al.Inhibition of neointimal proliferation with low-dose irradiation from a β-particle-emitting stent[J].Circulation,1996,93:529-536.
    [11] Janicki C,Duggan DM,Coffey CW,et al.Radiation dose from a phosphorous-32 impregnated wire mesh vascular stent[J].Med Phys,1997,24:437-445.
    [12] Dussaillant GR,Mintz GS,Pichard AD,et al.Small stent size and intimal hyperplasia contribute to restenosis:a volumetric intravascular ultrasound anal-ysis[J].J Am Coll Cardiol,1995,26:720-724.
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    [14] Serruys PW,Patrick KI.I like the candy,I hate the wrapper:The 32P radioactive stent[J].Circulation,2000,101:3-7.
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The problem of the “candy wrapper” for β-particle emitting stent implantation

  • Renji Hospital, Shanghai Second Medical University, Shanghai 200001, China

Abstract: There is an "edge effect" or "candy wrapper" problem at the stent edges for β-particle emitting stent im-plantation. The mechanism for "candy wrapper" may conclude low activity level of radiation, aggressive injury to vessel at the margins of the stent and neointimal proliferation due to low-dose radiation stimulation. The methods to solve the "candy wraper" could be proposed:(1) the square-shouldered balloon, (2) the cold-end stent, (3) the hot-end stent, (4) a self-expanding radioactive stent, (5) theγ-stent and so on.

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