Imaging of vascular injury with 99mTc-labeled monoclonal antiplatelet antibody S12

Preliminary experience in human percutaneous transluminal angioplasty

Donald D Miller, Frank J. Rivera, Oscar J. Garcia, Julio C. Palmaz, Harvey J. Berger, Harlan F. Weisman

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background. To evaluate the in vivo safety, biodistribution, and diagnostic accuracy of a monoclonal Fab' antibody (S12) that is specific for the platelet membrane glycoprotein (GMP-140) expressed during platelet activation at vascular injury sites, 11 peripheral percutaneous transluminal angioplasty (PTA) patients (age, 61±8 years) with severe vascular disease had serial 99mTc S12 radionuclide imaging at 5 and 90 minutes, 4-6 hours, and 20-24 hours after a total of 23 angiographically successful PTA procedures. No acute allergic reactions or hematologic toxicity occurred. Methods and Results. The average PTA percent angiographic diameter stenosis (DS) at all 23 sites decreased from 85±12% to 12±11%, with a mean before-to-after-PTA change of 73±14% (p<0.01). The mean radionuclide image-derived ratio of 99mTc S12 activity in PTA versus contralateral non-PTA arterial segments for all angioplasty sites was 1.6±0.5. Vascular 99mTc S12 antibody activity was qualitatively evident in the majority (78%) of PTA sites at 4-6 hours after injection. 99mTc S12 target-to-background (muscle) ratio equaled 2.3±0.6 at PTA sites. Nine PTA sites (39%) had residual 99mTc S12 activity at 24 hours after injection (mean PTA site-to-contralateral artery ratio, 1.5±0.4). The mean vascular 99mTc S12 activity ratios in 10 procedurally complicated (defined as extensive dilation [>2 cm] or grade I or greater arterial dissection) and 13 uncomplicated PTA segments were 1.9±0.5 versus 1.2±0.1, respectively (p<0.01). The associated before-to-after-PTA angiographic improvement was significantly less in procedurally complicated PTA sites (66±12% versus 80±12% DS; p<0.01). Conclusions. 99mTc S12 activity is significantly increased at angiographically patent PTA sites that are procedurally complicated and are associated with less significant before-to-after-PTA angiographic improvement. 99mTc S12 monoclonal Fab' antibody imaging permits noninvasive identification of local vascular platelet activation resulting from angioplasty balloon injury in humans.

Original languageEnglish (US)
Pages (from-to)1354-1363
Number of pages10
JournalCirculation
Volume85
Issue number4
DOIs
StatePublished - Jan 1 1992

Fingerprint

Vascular System Injuries
Angioplasty
Monoclonal Antibodies
Platelet Activation
Pathologic Constriction
Platelet Membrane Glycoproteins
P-Selectin
Balloon Angioplasty
Vascular Diseases
Radionuclide Imaging
Blood Vessels
Dissection
Hypersensitivity
Safety
Wounds and Injuries

Keywords

  • Monoclonal antibodies
  • Percutaneous transluminal angioplasty
  • Platelets
  • Radionuclide imaging
  • Restenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Imaging of vascular injury with 99mTc-labeled monoclonal antiplatelet antibody S12 : Preliminary experience in human percutaneous transluminal angioplasty. / Miller, Donald D; Rivera, Frank J.; Garcia, Oscar J.; Palmaz, Julio C.; Berger, Harvey J.; Weisman, Harlan F.

In: Circulation, Vol. 85, No. 4, 01.01.1992, p. 1354-1363.

Research output: Contribution to journalArticle

Miller, Donald D ; Rivera, Frank J. ; Garcia, Oscar J. ; Palmaz, Julio C. ; Berger, Harvey J. ; Weisman, Harlan F. / Imaging of vascular injury with 99mTc-labeled monoclonal antiplatelet antibody S12 : Preliminary experience in human percutaneous transluminal angioplasty. In: Circulation. 1992 ; Vol. 85, No. 4. pp. 1354-1363.
@article{b6e205360d844425aaa9589ff59528f9,
title = "Imaging of vascular injury with 99mTc-labeled monoclonal antiplatelet antibody S12: Preliminary experience in human percutaneous transluminal angioplasty",
abstract = "Background. To evaluate the in vivo safety, biodistribution, and diagnostic accuracy of a monoclonal Fab' antibody (S12) that is specific for the platelet membrane glycoprotein (GMP-140) expressed during platelet activation at vascular injury sites, 11 peripheral percutaneous transluminal angioplasty (PTA) patients (age, 61±8 years) with severe vascular disease had serial 99mTc S12 radionuclide imaging at 5 and 90 minutes, 4-6 hours, and 20-24 hours after a total of 23 angiographically successful PTA procedures. No acute allergic reactions or hematologic toxicity occurred. Methods and Results. The average PTA percent angiographic diameter stenosis (DS) at all 23 sites decreased from 85±12{\%} to 12±11{\%}, with a mean before-to-after-PTA change of 73±14{\%} (p<0.01). The mean radionuclide image-derived ratio of 99mTc S12 activity in PTA versus contralateral non-PTA arterial segments for all angioplasty sites was 1.6±0.5. Vascular 99mTc S12 antibody activity was qualitatively evident in the majority (78{\%}) of PTA sites at 4-6 hours after injection. 99mTc S12 target-to-background (muscle) ratio equaled 2.3±0.6 at PTA sites. Nine PTA sites (39{\%}) had residual 99mTc S12 activity at 24 hours after injection (mean PTA site-to-contralateral artery ratio, 1.5±0.4). The mean vascular 99mTc S12 activity ratios in 10 procedurally complicated (defined as extensive dilation [>2 cm] or grade I or greater arterial dissection) and 13 uncomplicated PTA segments were 1.9±0.5 versus 1.2±0.1, respectively (p<0.01). The associated before-to-after-PTA angiographic improvement was significantly less in procedurally complicated PTA sites (66±12{\%} versus 80±12{\%} DS; p<0.01). Conclusions. 99mTc S12 activity is significantly increased at angiographically patent PTA sites that are procedurally complicated and are associated with less significant before-to-after-PTA angiographic improvement. 99mTc S12 monoclonal Fab' antibody imaging permits noninvasive identification of local vascular platelet activation resulting from angioplasty balloon injury in humans.",
keywords = "Monoclonal antibodies, Percutaneous transluminal angioplasty, Platelets, Radionuclide imaging, Restenosis",
author = "Miller, {Donald D} and Rivera, {Frank J.} and Garcia, {Oscar J.} and Palmaz, {Julio C.} and Berger, {Harvey J.} and Weisman, {Harlan F.}",
year = "1992",
month = "1",
day = "1",
doi = "10.1161/01.CIR.85.4.1354",
language = "English (US)",
volume = "85",
pages = "1354--1363",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Imaging of vascular injury with 99mTc-labeled monoclonal antiplatelet antibody S12

T2 - Preliminary experience in human percutaneous transluminal angioplasty

AU - Miller, Donald D

AU - Rivera, Frank J.

AU - Garcia, Oscar J.

AU - Palmaz, Julio C.

AU - Berger, Harvey J.

AU - Weisman, Harlan F.

PY - 1992/1/1

Y1 - 1992/1/1

N2 - Background. To evaluate the in vivo safety, biodistribution, and diagnostic accuracy of a monoclonal Fab' antibody (S12) that is specific for the platelet membrane glycoprotein (GMP-140) expressed during platelet activation at vascular injury sites, 11 peripheral percutaneous transluminal angioplasty (PTA) patients (age, 61±8 years) with severe vascular disease had serial 99mTc S12 radionuclide imaging at 5 and 90 minutes, 4-6 hours, and 20-24 hours after a total of 23 angiographically successful PTA procedures. No acute allergic reactions or hematologic toxicity occurred. Methods and Results. The average PTA percent angiographic diameter stenosis (DS) at all 23 sites decreased from 85±12% to 12±11%, with a mean before-to-after-PTA change of 73±14% (p<0.01). The mean radionuclide image-derived ratio of 99mTc S12 activity in PTA versus contralateral non-PTA arterial segments for all angioplasty sites was 1.6±0.5. Vascular 99mTc S12 antibody activity was qualitatively evident in the majority (78%) of PTA sites at 4-6 hours after injection. 99mTc S12 target-to-background (muscle) ratio equaled 2.3±0.6 at PTA sites. Nine PTA sites (39%) had residual 99mTc S12 activity at 24 hours after injection (mean PTA site-to-contralateral artery ratio, 1.5±0.4). The mean vascular 99mTc S12 activity ratios in 10 procedurally complicated (defined as extensive dilation [>2 cm] or grade I or greater arterial dissection) and 13 uncomplicated PTA segments were 1.9±0.5 versus 1.2±0.1, respectively (p<0.01). The associated before-to-after-PTA angiographic improvement was significantly less in procedurally complicated PTA sites (66±12% versus 80±12% DS; p<0.01). Conclusions. 99mTc S12 activity is significantly increased at angiographically patent PTA sites that are procedurally complicated and are associated with less significant before-to-after-PTA angiographic improvement. 99mTc S12 monoclonal Fab' antibody imaging permits noninvasive identification of local vascular platelet activation resulting from angioplasty balloon injury in humans.

AB - Background. To evaluate the in vivo safety, biodistribution, and diagnostic accuracy of a monoclonal Fab' antibody (S12) that is specific for the platelet membrane glycoprotein (GMP-140) expressed during platelet activation at vascular injury sites, 11 peripheral percutaneous transluminal angioplasty (PTA) patients (age, 61±8 years) with severe vascular disease had serial 99mTc S12 radionuclide imaging at 5 and 90 minutes, 4-6 hours, and 20-24 hours after a total of 23 angiographically successful PTA procedures. No acute allergic reactions or hematologic toxicity occurred. Methods and Results. The average PTA percent angiographic diameter stenosis (DS) at all 23 sites decreased from 85±12% to 12±11%, with a mean before-to-after-PTA change of 73±14% (p<0.01). The mean radionuclide image-derived ratio of 99mTc S12 activity in PTA versus contralateral non-PTA arterial segments for all angioplasty sites was 1.6±0.5. Vascular 99mTc S12 antibody activity was qualitatively evident in the majority (78%) of PTA sites at 4-6 hours after injection. 99mTc S12 target-to-background (muscle) ratio equaled 2.3±0.6 at PTA sites. Nine PTA sites (39%) had residual 99mTc S12 activity at 24 hours after injection (mean PTA site-to-contralateral artery ratio, 1.5±0.4). The mean vascular 99mTc S12 activity ratios in 10 procedurally complicated (defined as extensive dilation [>2 cm] or grade I or greater arterial dissection) and 13 uncomplicated PTA segments were 1.9±0.5 versus 1.2±0.1, respectively (p<0.01). The associated before-to-after-PTA angiographic improvement was significantly less in procedurally complicated PTA sites (66±12% versus 80±12% DS; p<0.01). Conclusions. 99mTc S12 activity is significantly increased at angiographically patent PTA sites that are procedurally complicated and are associated with less significant before-to-after-PTA angiographic improvement. 99mTc S12 monoclonal Fab' antibody imaging permits noninvasive identification of local vascular platelet activation resulting from angioplasty balloon injury in humans.

KW - Monoclonal antibodies

KW - Percutaneous transluminal angioplasty

KW - Platelets

KW - Radionuclide imaging

KW - Restenosis

UR - http://www.scopus.com/inward/record.url?scp=0026591468&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026591468&partnerID=8YFLogxK

U2 - 10.1161/01.CIR.85.4.1354

DO - 10.1161/01.CIR.85.4.1354

M3 - Article

VL - 85

SP - 1354

EP - 1363

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 4

ER -