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External beam radiation after stent implantation increases neointimal hyperplasia by augmenting smooth muscle cell proliferation and extracellular matrix accumulation

Christoph Hehrlein, MD^*, Simone Kaiser, BS^*, Reimer Riessen, MD, J.ürgen Metz, MD, Peter Fritz, MD and Wolfgang Kübler, MD^*

^* Department of Cardiology, University of Heidelberg, Heidelberg, Germany
Department of Anatomy and Cell Biology, University of Heidelberg, Heidelberg, Germany
Department of Clinical Radiology, University of Heidelberg, Heidelberg, Germany
Department of Cardiology, University of Tübingen, Tübingen, Germany

View larger version (47K): [in a new window]   Figure 1 Northern blot demonstrating increased expression of collagen type I (7.2- and 5.5-kDa band) and biglycan (2.8-kDa band) in the stented arteries exposed to external beam radiation at a dose of 2 x 8 Gy (16 Gy) compared with 8 Gy and nonirradiated arteries. The 18-S rRNA band documents equal loading and RNA transfer (control).

View larger version (49K): [in a new window]   Figure 2 (A) Histologic image showing neointima covering a nonirradiated stent 12 weeks after implantation in the rabbit iliac artery. *Denotes area of removed stent wire. (B) Histologic image illustrating extracellular matrix accumulation in the neointima at 12 weeks after stenting and external beam radiation with 16 Gy, indicated by the low density of neointimal cells. *Denotes region of removed stent wire. Magnification x400.