Relationship between tensile stress and plaque growth after balloon angioplasty treated with and without intracoronary beta-brachytherapy

Aims We investigated the influence of tensile stress on plaque growth after balloon angioplasty with and without beta-radiation therapy. Methods and Results Thirty-one consecutive patients successfully treated wi th balloon angioplasty were analysed qualitatively and quantitatively by me ans of an EGG-gated three-dimensional intravascular ultrasound post-procedu re and at follow-up. Eighteen patients were irradiated with catheter-based beta-radiation (Sr-90/Y-90 source) and 13 were not (control). Studied segme nts were divided into 2 mm subsegments. Thus 184 irradiated and 111 non-irr adiated subsegments were included. Tensile stress was calculated according to Laplace's law. The radiation dose was calculated by means of dose-volume histograms. Plaque growth was positively correlated to tensile stress in b oth the radiation and control groups (r=0.374, P=0.0001 and r=0.305, P=0.00 1). Low-dose subsegments (<6 Gy) had a significant correlation (r=0.410, P= 0.0001) whereas no correlation was observed in the effective-dose subsegmen ts (<greater than or equal to>6 Gy). Multivariate analysis identified tensi le stress as the only independent predictor of plaque increase in non-irrad iated subsegments, whereas actual dose and plaque morphology were stronger predictors in irradiated subsegments. Conclusion The results of this study suggest that plaque growth is related to tensile stress after balloon angioplasty. Intracoronary brachytherapy ma y alter the biophysical process on plaque growth when the prescribed dose i s effectively delivered. (C) 2000 The European Society of Cardiology.