Psoralen and long wavelength ultraviolet radiation as an adjuvant therapy for prevention of intimal hyperplasia and constrictive remodeling after balloon dilation: A study in the rabbit iliac artery

Background and Objective: Restenosis after balloon angioplasty is the summa ted effect of intimal hyperplasia and arterial shrinkage, both caused by hy perproliferation. In the present study, the potential of a photochemotherap eutic modality (Psoralen + UVA: PUVA) for the prevention of angioplasty ind uced proliferation was explored. Study Design/Materials and Methods: In rabbit iliac arteries, balloon dilat ion followed by PUVA-therapy (H = 1 J/cm(2)) was performed (n = 15). Contra lateral arteries served as control. After 2 and 28 days of survival, the co ntribution of intimal hyperplasia and remodeling to lumen loss was determin ed by means of angiography and histological analysis. Results: After 2 days, large parts of the media had become acellular, while proliferation was occurring predominantly in the adventitia in both groups . After 28 days, late loss, arterial shrinkage, but not intimal hyperplasia were larger in the PUVA group (P < 0.05). Conclusion: PUVA-therapy did not prevent intimal hyperplasia following ball oon dilation but enhanced luminal narrowing by augmented constrictive remod eling. (C) 1998 Wiley-Liss, Inc.