Gabeler Edward E E, van Hillegersberg Richard, Sluiter Wim, Kliffen Mike, Statius van Eps Randolph G, Honkoop Jan, Carlier Stephane G, van Urk Hero
Department of Surgery, Erasmus MC, Rotterdam, The Netherlands.
Lasers Surg Med. 2003;33(1):8-15. doi: 10.1002/lsm.10187.
Vascular photodynamic therapy (PDT) inhibits intimal hyperplasia (IH) induced by angioplasty in rat iliac arteries by eradicating the proliferating smooth muscle cells. This process may jeopardise the structure and strength of the arterial wall, reflected by a decreased bursting pressure.
STUDY DESIGN/MATERIALS AND METHODS: Thirty male Wistar rats of 250-300 g were subdivided into 3 groups (n = 10). In all groups, IH was induced by balloon injury (BI). One experimental group received PDT at 50 J/cm diffuser length, the other group at 100 J/cm diffuser length. The third group served as control group and received no PDT. In half of each group the bursting pressure was analyzed after 2 hours (n = 5), in the other half after 1 year.
Two hours after the procedure the bursting pressure was 3.37 +/- 0.58 (+/-SEM) bar in the BI + PDT 50 and 3.96 +/- 0.43 bar in the BI + PDT 100 group, compared to 2.20 +/- 0.27 bar in the BI group (P < 0.05). After 1 year these values were 3.18 +/- 0.87 bar in the BI + PDT 50 (P < 0.05) and 2.02 +/- 0.31 bar in the BI + PDT 100 group, compared to 2.10 +/- 0.30 bar in the BI group (NS). In the BI + PDT 100 group, 3 out of 5 rats appeared to have aneurysmal dilatation after 1 year.
Endovascular PDT increases the arterial wall strength as measured by the bursting pressure at short-term. After 1 year, wall strength is not diminished as measured by bursting pressure, but aneurysmal dilatation nevertheless developed with 100 J/cm. dl. This may limit the use of high energy PDT.
血管光动力疗法（PDT）通过消除增殖的平滑肌细胞来抑制大鼠髂动脉血管成形术诱导的内膜增生（IH）。这一过程可能会危及动脉壁的结构和强度，表现为破裂压力降低。
研究设计/材料与方法：将30只体重250 - 300克的雄性Wistar大鼠分为3组（每组n = 10）。所有组均通过球囊损伤（BI）诱导内膜增生。一个实验组接受50 J/cm扩散器长度的PDT治疗，另一组接受100 J/cm扩散器长度的PDT治疗。第三组作为对照组，不接受PDT治疗。每组一半大鼠在术后2小时分析破裂压力（n = 5），另一半在术后1年分析。
术后2小时，BI + PDT 50组的破裂压力为3.37±0.58（±SEM）巴，BI + PDT 100组为3.96±0.43巴，而BI组为2.20±0.27巴（P < 0.05）。1年后，BI + PDT 50组的值为3.18±0.87巴（P < 0.05），BI + PDT 100组为2.02±0.31巴，BI组为2.10±0.30巴（无显著差异）。在BI + PDT 100组中，5只大鼠中有3只在1年后出现动脉瘤样扩张。
血管内PDT在短期内通过破裂压力测量可增加动脉壁强度。1年后，通过破裂压力测量壁强度并未降低，但100 J/cm. dl的剂量仍出现了动脉瘤样扩张。这可能会限制高能PDT的应用。
