Radiation injury to coronary artery is rarely given a thought , in spite of prolonged fluro-scopic time during many complex angioplasties.While the cardiologists are fully protected the patient’s heart takes on the brunt of the attack.
What happens to the coronary endothelium -metal interface when X -rays pass through it ?
It is well known the radiation delivered to a tissue is many times amplified if a metal interface is present. Further , the metals can produce heat on exposure to radiation . This absorption and heat varies with different metals .
The radiation injury to coronary endothelium could be significantly higher with DES , as the polymer in it absorbs more radiation than the bare metal stent. This could be responsible for late complications of DES.
The above concept (unproven though !) is proposed by http://circ.ahajournals.org/cgi/content/full/104/5/e23 .In this study Gold coated coronary stents were found to be less safe than conventional stent
It may take many years to know the truths about radiation injury caused by of coronary stents .
But always remember , unproven concepts are not synonymous with wrong concepts !
Dr.S.Venkatesan MD 