Stenosis following laser thermal angioplasty—A blinded controlled randomized study between aspirin against probucol

Abstract Long-term patency of vascular angioplasties is limited by stenosis from neointimal hyperplasia or progressive arteriosclerosis. This study evaluated the hypothesis that ASA (an antiprostaglandin) or Probucol (an antioxidant) may be useful in preventing stenosis following laser thermal angioplasty. Aortoiliac arteriosclerosis was induced in 17 female New Zealand white rabbits with a combination of endothelial denudation (4 Fr. Fogarty balloon catheters) and 2% cholesterol-supplemented diet for 6 weeks. All rabbits then underwent arteriography and were immediately randomized to one of three groups: Group I ( n = 6), control, laser but no adjunctive therapy; Group II ( n = 5), laser and ASA 10 mg/kg/day; Group III ( n = 6), laser and 1% Probucol diet. Retrograde laser thermal angioplasty was performed with a 1-mm coronary Laserprobe. Six watts of argon laser energy was delivered for a single 5-sec pulse using a continuous motion from the right common iliac artery to the aorta. Pre- and postlaser arteriography was performed in all groups. Rabbits were sacrificed 1 month following laser angioplasty, and aortoiliac sections were taken after in situ perfusion fixation with paraformaldehyde and 0.05% glutaraldehyde. Serial 5-mm segments, proximal to the aortic bifurcation and distally from the same, were taken, stained, and evaluated by quantitative morphometry. From each segment, lesion area and lesion area/internal elastic laminae area were evaluated and compared. Serum cholesterol increased from 60.8 ± 19.5 to 1494.7 ± 12.7 mg% following institution of the cholesterol diet ( P 11 14 stenosed iliac sections were enlarged ( P 6 14 aortic lesions ( P = NS). Aortic and iliac sections from all groups examined histologically 1 month after laser angioplasty showed no significant differences in lesion size and lesion area/IEL area. Laser angioplasty increases luminal size immediately, but neither the addition of ASA nor the addition of Probucol postoperatively affects final lesion size.