Psoralen and long wavelength ultraviolet radiation as an adjuvant therapy for prevention of intimal hyperplasia and constrictive remodeling after balloon dilation: a study in the rabbit iliac artery

BACKGROUND AND OBJECTIVE: Restenosis after balloon angioplasty is the summated effect of intimal hyperplasia and arterial shrinkage, both caused by hyperproliferation. In the present study, the potential of a photochemotherapeutic modality (Psoralen + UVA: PUVA) for the prevention of angioplasty induced proliferation was explored. STUDY DESIGN/MATERIALS AND METHODS: In rabbit iliac arteries, balloon dilation followed by PUVA-therapy (H = 1 J/cm2) was performed (n = 15). Contralateral arteries served as control. After 2 and 28 days of survival, the contribution of intimal hyperplasia and remodeling to lumen loss was determined by means of angiography and histological analysis. RESULTS: After 2 days, large parts of the media had become acellular, while proliferation was occurring predominantly in the adventitia in both groups. After 28 days, late loss, arterial shrinkage, but not intimal hyperplasia were larger in the PUVA group (P <0.05). CONCLUSION: PUVA-therapy did not prevent intimal hyperplasia following balloon dilation but enhanced luminal narrowing by augmented constrictive remodeling