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during stent implantation into saphenous vein aortocoronary bypass grafts and its relation to plaque extrusion and restenosis
1 Cardiology, University of Essen, Essen, Germany
2 Pathophysiology, University of Essen, Essen, Germany
3 Essen, Germany; Pathophysiology, University of Essen, Essen, Germany
4 Clinical Chemistry, University of Essen, Essen, Germany
5 Essen, Germany; Clinical Chemistry, University of Essen, Essen, Germany
6 Cardiology, University of Essen, Essen, Germany; Essen, Germany
* To whom correspondence should be addressed. E-mail: gerd.heusch{at}uk-essen.de.
The reduction in plaque volume during stent implantation is associated with the release of particulate debris and plaque-derived soluble substances. We studied the potential release of the pro-inflammatory cytokine tumor necrosis factor-
(TNF) into the coronary circulation and whether such release is related to the reduction in plaque volume and possibly a predictor for restenosis.
In eighteen male patients (=24 stents) with a severe stenosis in their saphenous vein aortocoronary bypass graft (SVG) we used a distal balloon occlusion/aspiration device during stenting. The aspirate TNF levels were determined before and after stenting and related to the angiographic and intravascular ultrasound-assessed severity of stenosis and to restenosis.
We found that TNF is indeed released into the aspirate of stented SVG (TNF in pg/ml, before: 9±1 vs. after stenting: 28±3; with p<0.0001) and that such release is related to the reduction in plaque volume (r=0.88, p<0.0001) and associated with restenosis after five months (r=0.71, p=0.001).
The periprocedural release of plaque-derived TNF possibly represents the amount and activity of the atherosclerotic process and might be a predictor for restenosis.
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