The black hole: Echolucent tissue observed following intracoronary radiation

I. Patrick Kay; Jurgen M.R. Ligthart; Renu Virmani; Heleen M.M. Van Beusekom; Ken Kozuma; Andrew J. Carter; Georgios Sianos; Willem J. Van Der Giessen; Alexander J. Wardeh; Pim J. De Feyter; Patrick W. Serruys

doi:10.1080/14628840310007673

The black hole: Echolucent tissue observed following intracoronary radiation

I. Patrick Kay, Jurgen M.R. Ligthart, Renu Virmani, Heleen M.M. Van Beusekom, Ken Kozuma, Andrew J. Carter, Georgios Sianos, Willem J. Van Der Giessen, Alexander J. Wardeh, Pim J. De Feyter, Patrick W. Serruys

Research output: Contribution to a Journal (Peer & Non Peer) › Article › peer-review

22 Citations (Scopus)

Abstract

AIMS: Recent trials in humans have given us insight into some of the consequences of intracoronary radiation. The authors describe a new observation noted on intravascular ultrasound: that of intraluminal echolucent tissue, dubbed the 'black hole', noted at six-month follow-up. METHODS AND RESULTS: One hundred and twenty-eight consecutive patients enrolled in brachytherapy protocols were analyzed. The control group (C) consisted of individuals who underwent percutaneous transluminal coronary angioplasty with (n = 48) and without (n = 22) stent implantation. Radiation groups included those who underwent low activity (LA) (n = 18), high activity (HA) (n = 26) and cold-end (CE) (n = 18) radioactive stenting. The Novoste Betacath (n = 39) and Guidant (n = 27) catheter-based radiation systems were also employed. At six-month follow-up echolucent tissue was identified in a total of 28 cases (22%). Angiographic restenosis occurred in 17 cases (61%). No echolucent tissue was seen in the control group or in the LA group. HA and CE radioactive stents were most commonly associated with echolucent tissue. Echolucent tissue was seen in all groups treated with catheter-based radiation with and without stenting. Pathology after atherectomy demonstrated smooth muscle cells scattered in extracellular matrix containing abundant proteoglycans and an absence of elastin and mature collagen. CONCLUSIONS: Echolucent tissue is common after radioactive stenting. It is composed of tissue rich in proteoglycans while poor in mature collagen and elastin.

Original language	English
Pages (from-to)	137-142
Number of pages	6
Journal	International Journal of Cardiovascular Interventions
Volume	5
Issue number	3
DOIs	https://doi.org/10.1080/14628840310007673
Publication status	Published - 2003
Externally published	Yes

Keywords

Proteoglycan
Radiation
Ultrasonics

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/14628840310007673

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Kay, I. P., Ligthart, J. M. R., Virmani, R., Van Beusekom, H. M. M., Kozuma, K., Carter, A. J., Sianos, G., Van Der Giessen, W. J., Wardeh, A. J., De Feyter, P. J., & Serruys, P. W. (2003). The black hole: Echolucent tissue observed following intracoronary radiation. International Journal of Cardiovascular Interventions, 5(3), 137-142. https://doi.org/10.1080/14628840310007673

@article{58fb3dd5b9e4498f9f56ac299b69ec2a,

title = "The black hole: Echolucent tissue observed following intracoronary radiation",

abstract = "AIMS: Recent trials in humans have given us insight into some of the consequences of intracoronary radiation. The authors describe a new observation noted on intravascular ultrasound: that of intraluminal echolucent tissue, dubbed the 'black hole', noted at six-month follow-up. METHODS AND RESULTS: One hundred and twenty-eight consecutive patients enrolled in brachytherapy protocols were analyzed. The control group (C) consisted of individuals who underwent percutaneous transluminal coronary angioplasty with (n = 48) and without (n = 22) stent implantation. Radiation groups included those who underwent low activity (LA) (n = 18), high activity (HA) (n = 26) and cold-end (CE) (n = 18) radioactive stenting. The Novoste Betacath (n = 39) and Guidant (n = 27) catheter-based radiation systems were also employed. At six-month follow-up echolucent tissue was identified in a total of 28 cases (22\%). Angiographic restenosis occurred in 17 cases (61\%). No echolucent tissue was seen in the control group or in the LA group. HA and CE radioactive stents were most commonly associated with echolucent tissue. Echolucent tissue was seen in all groups treated with catheter-based radiation with and without stenting. Pathology after atherectomy demonstrated smooth muscle cells scattered in extracellular matrix containing abundant proteoglycans and an absence of elastin and mature collagen. CONCLUSIONS: Echolucent tissue is common after radioactive stenting. It is composed of tissue rich in proteoglycans while poor in mature collagen and elastin.",

keywords = "Proteoglycan, Radiation, Ultrasonics",

author = "Kay, \{I. Patrick\} and Ligthart, \{Jurgen M.R.\} and Renu Virmani and \{Van Beusekom\}, \{Heleen M.M.\} and Ken Kozuma and Carter, \{Andrew J.\} and Georgios Sianos and \{Van Der Giessen\}, \{Willem J.\} and Wardeh, \{Alexander J.\} and \{De Feyter\}, \{Pim J.\} and Serruys, \{Patrick W.\}",

year = "2003",

doi = "10.1080/14628840310007673",

language = "English",

volume = "5",

pages = "137--142",

journal = "International Journal of Cardiovascular Interventions",

issn = "1462-8848",

publisher = "Taylor and Francis Ltd.",

number = "3",

}

TY - JOUR

T1 - The black hole

T2 - Echolucent tissue observed following intracoronary radiation

AU - Kay, I. Patrick

AU - Ligthart, Jurgen M.R.

AU - Virmani, Renu

AU - Van Beusekom, Heleen M.M.

AU - Kozuma, Ken

AU - Carter, Andrew J.

AU - Sianos, Georgios

AU - Van Der Giessen, Willem J.

AU - Wardeh, Alexander J.

AU - De Feyter, Pim J.

AU - Serruys, Patrick W.

PY - 2003

Y1 - 2003

N2 - AIMS: Recent trials in humans have given us insight into some of the consequences of intracoronary radiation. The authors describe a new observation noted on intravascular ultrasound: that of intraluminal echolucent tissue, dubbed the 'black hole', noted at six-month follow-up. METHODS AND RESULTS: One hundred and twenty-eight consecutive patients enrolled in brachytherapy protocols were analyzed. The control group (C) consisted of individuals who underwent percutaneous transluminal coronary angioplasty with (n = 48) and without (n = 22) stent implantation. Radiation groups included those who underwent low activity (LA) (n = 18), high activity (HA) (n = 26) and cold-end (CE) (n = 18) radioactive stenting. The Novoste Betacath (n = 39) and Guidant (n = 27) catheter-based radiation systems were also employed. At six-month follow-up echolucent tissue was identified in a total of 28 cases (22%). Angiographic restenosis occurred in 17 cases (61%). No echolucent tissue was seen in the control group or in the LA group. HA and CE radioactive stents were most commonly associated with echolucent tissue. Echolucent tissue was seen in all groups treated with catheter-based radiation with and without stenting. Pathology after atherectomy demonstrated smooth muscle cells scattered in extracellular matrix containing abundant proteoglycans and an absence of elastin and mature collagen. CONCLUSIONS: Echolucent tissue is common after radioactive stenting. It is composed of tissue rich in proteoglycans while poor in mature collagen and elastin.

AB - AIMS: Recent trials in humans have given us insight into some of the consequences of intracoronary radiation. The authors describe a new observation noted on intravascular ultrasound: that of intraluminal echolucent tissue, dubbed the 'black hole', noted at six-month follow-up. METHODS AND RESULTS: One hundred and twenty-eight consecutive patients enrolled in brachytherapy protocols were analyzed. The control group (C) consisted of individuals who underwent percutaneous transluminal coronary angioplasty with (n = 48) and without (n = 22) stent implantation. Radiation groups included those who underwent low activity (LA) (n = 18), high activity (HA) (n = 26) and cold-end (CE) (n = 18) radioactive stenting. The Novoste Betacath (n = 39) and Guidant (n = 27) catheter-based radiation systems were also employed. At six-month follow-up echolucent tissue was identified in a total of 28 cases (22%). Angiographic restenosis occurred in 17 cases (61%). No echolucent tissue was seen in the control group or in the LA group. HA and CE radioactive stents were most commonly associated with echolucent tissue. Echolucent tissue was seen in all groups treated with catheter-based radiation with and without stenting. Pathology after atherectomy demonstrated smooth muscle cells scattered in extracellular matrix containing abundant proteoglycans and an absence of elastin and mature collagen. CONCLUSIONS: Echolucent tissue is common after radioactive stenting. It is composed of tissue rich in proteoglycans while poor in mature collagen and elastin.

KW - Proteoglycan

KW - Radiation

KW - Ultrasonics

UR - https://www.scopus.com/pages/publications/0141427726

U2 - 10.1080/14628840310007673

DO - 10.1080/14628840310007673

M3 - Article

C2 - 12959730

AN - SCOPUS:0141427726

SN - 1462-8848

VL - 5

SP - 137

EP - 142

JO - International Journal of Cardiovascular Interventions

JF - International Journal of Cardiovascular Interventions

IS - 3

ER -

The black hole: Echolucent tissue observed following intracoronary radiation

Abstract

Keywords

UN SDGs

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