PMID- 15481610
OWN - NLM
STAT- MEDLINE
DCOM- 20050111
LR  - 20190608
IS  - 1226-3303 (Print)
IS  - 2005-6648 (Electronic)
IS  - 1226-3303 (Linking)
VI  - 19
IP  - 3
DP  - 2004 Sep
TI  - A novel method of brachytherapy using local delivery of 99mTc-HMPAO for coronary 
      stent restenosis.
PG  - 179-88
AB  - BACKGROUND: Restenosis after percutaneous coronary intervention (PCI) is a matter 
      that still remains to be resolved. Herein, the inhibitory effect of locally 
      delivered 99mTc-HMPAO (hexamethyl propylene amine oxime) on neointimal 
      hyperplasia after coronary stenting was examined in a pocine model, and its 
      safety and efficacy observed in patients with coronary stent restenosis. METHODS: 
      After a stent overdilation injury, local radioisotope delivery using 99mTc-HMPAO 
      was applied to one coronary artery (Group I) and control therapy to another 
      (Group II) in each of 10 pigs. Follow-up coronary angiogram (CAG) and 
      histopathologic assessment were performed 4 weeks after stenting. Eleven patients 
      (10 males and one female, 62.4 +/- 5.7 years of age) underwent local 
      administration of 30 mCi/ 2 mL 99mTc-HMPAO shortly after PCI, via a Dispatch 
      Catheter, followed by a whole body scan to evaluate the distribution of the 
      99mTc-HMPAO, as well as a thallium-201 (TI-201) myocardial scan to evaluate 
      myocardial perfusion. The major adverse cardiac events (MACE) were assessed 
      during a one-year clinical follow-up. RESULTS: On histopathological analysis, the 
      neointimal areas were 1.2 +/- 0.6 and 2.7 +/- 0.4 mm2 (p=0.002), and the 
      histopathological areas of stenosis were 27.16.3 and 53.4 +/- 5.2% in Groups I 
      and II (p=0.001), respectively. In the clinical study, there was no in-hospital 
      MACE. On a quantitative coronary angiographic analysis, the minimal luminal 
      diameter was increased from 0.4 +/- 0.3 to 2.9 +/- 0.2 mm, and diameter stenosis 
      decreased from 84.2 +/- 9.5 to 16.3 +/- 11.0% following PCI. Follow-up CAG was 
      performed in 9 cases (81.8%) and restenosis occurred in 2 (22.2%). On a follow-up 
      CAG, the minimal luminal diameter, diameter stenosis rate, lumen loss and loss 
      index were 2.0 +/- 0.8 mm, 27.7 +/- 2.9%, 0.7 +/- 0.7 mm and 0.2 +/- 0.3, 
      respectively. During the one-year clinical follow-up there were no cases of death 
      or acute MI, but two cases of target vessel revascularization (18.2%). 
      CONCLUSION: Local delivery of 99mTc-HMPAO, a novel radiotherapy, can be used 
      safely and effectively for coronary stent restenosis.
FAU - Kim, Weon
AU  - Kim W
AD  - The Heart Center, Chonnam National University Hospital, Gwangju, Korea.
FAU - Jeong, Myung Ho
AU  - Jeong MH
FAU - Kim, Sung Hee
AU  - Kim SH
FAU - Park, Woo Seok
AU  - Park WS
FAU - Park, Ok Young
AU  - Park OY
FAU - Kim, Ju Han
AU  - Kim JH
FAU - Bom, Hee-Seung
AU  - Bom HS
FAU - Jeong, Hwan Jung
AU  - Jeong HJ
FAU - Ahn, Young Keun
AU  - Ahn YK
FAU - Cho, Jeong Gwan
AU  - Cho JG
FAU - Park, Jong Chun
AU  - Park JC
FAU - Kang, Jung Chaee
AU  - Kang JC
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Korea (South)
TA  - Korean J Intern Med
JT  - The Korean journal of internal medicine
JID - 8712418
RN  - 0 (Radiopharmaceuticals)
RN  - 3B744AG22N (Technetium Tc 99m Exametazime)
SB  - IM
MH  - Angioplasty, Balloon, Coronary
MH  - Animals
MH  - Brachytherapy/*methods
MH  - Coronary Angiography
MH  - Coronary Restenosis/*radiotherapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Radiopharmaceuticals/*therapeutic use
MH  - *Stents
MH  - Swine
MH  - Technetium Tc 99m Exametazime/*therapeutic use
PMC - PMC4531558
EDAT- 2004/10/16 09:00
MHDA- 2005/01/12 09:00
PMCR- 2004/09/01
CRDT- 2004/10/16 09:00
PHST- 2004/10/16 09:00 [pubmed]
PHST- 2005/01/12 09:00 [medline]
PHST- 2004/10/16 09:00 [entrez]
PHST- 2004/09/01 00:00 [pmc-release]
AID - kjim-19-3-179-8 [pii]
AID - 10.3904/kjim.2004.19.3.179 [doi]
PST - ppublish
SO  - Korean J Intern Med. 2004 Sep;19(3):179-88. doi: 10.3904/kjim.2004.19.3.179.