Abstract Number: PB0023
Meeting: ISTH 2021 Congress
Background: Intimal hyperplasia refers to proliferation and migration of vascular smooth muscle cells primarily in the tunica intima, resulting in arterial wall thickening and decreased arterial lumen size. Neointimal hyperplasia is the major cause of restenosis after percutaneous carotid interventions such as stenting or angioplasty. Photodynamic therapy is a two-stage treatment that combines light energy with a drug (photosensitizer) designed to destroy cancerous, precancerous and hyperplasia cells after light activation. Photosensitizers are activated by a specific wavelength of light energy. 5-Aminolevulinic Acid is an endogenous precursor of the natural photosensitizer protoporphyrin IX.
Aims: To investigate the effect of 5-Aminolevulinic Acid activated by low-level red laser on cerebrovascular neointimal hyperplasia in a prospective animal cohort study, wherein diagnostic B- mode ultrasound is combined with laser system, with a goal of increased safety.
Methods: Endothelial balloon catheter denudation of the right common carotid artery of Golden Syrian Hamsters (n=10) was performed. Histopathologic evaluation confirmed neointimal hyperplasia formation in all of the hamsters’ arteries. The treatment group underwent intravenous 5- Aminolevulinic Acid administration accompanied by catheter- based low-level red laser (λ= 650 nm, E/A= 10 J/cm2) photodynamic therapy guided by simultaneous B- mode ultrasound imaging.
Results: B- mode ultrasound guided photodynamic therapy was feasible and appeared safe for the targeting of stenosis in the carotid artery. Furthermore, histopathologic results showed a significant reduction in the mean value for smooth muscle cells density, lumen wall thickness and percentage of luminal cross- sectional area of stenosis in the treatment group (p<0.05).
Conclusions: 5-Aminolevulinic Acid in conjunction with low-level red laser is significantly associated with reduced carotid artery stenosis in hamsters. The mechanism may relate to reduced smooth muscle hyperplasia in the tunica intima.
To cite this abstract in AMA style:Mehrad H, Sultan- Qurraie A. Photodynamic Therapy with 5- Aminolevulinic Acid and B-mode Ultrasound-guided Catheter-based Low-level Red Laser Results in Cerebrovascular Neointimal Hyperplasia Regression [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/photodynamic-therapy-with-5-aminolevulinic-acid-and-b-mode-ultrasound-guided-catheter-based-low-level-red-laser-results-in-cerebrovascular-neointimal-hyperplasia-regression/. Accessed October 20, 2021.
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