Document Detail

Intracoronary beta-irradiation for the treatment of de novo lesions: 5-year clinical follow-up of the BetAce randomized trial.
MedLine Citation:
PMID:  17307419     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Vascular brachytherapy (VBT) has been used for the prevention of restenosis. Despite initial positive results, long-term follow-up has shown a progressive loss of benefit in clinical outcome after beta-irradiation. We report the 5-year follow-up of the BetAce trial. METHODS: This prospective, randomized, single-blind trial included 61 patients treated for 64 de novo coronary lesions: 31 patients (33 stenoses) were treated with bare metal stents (control group), and 30 patients (31 stenoses) were treated with intracoronary beta-irradiation at the time of stented angioplasty (VBT group). RESULTS: Baseline and procedural data were similar between treatment arms. At 6 months, VBT reduced the need for target vessel revascularization (13% vs 35.5%, P = .04), but there was no significant difference in the 6- and 12-month event-free survival when clinical events were ranked. Between 1 and 5 years, an increasing number of target vessel failures was observed in both groups, leading to a similar long-term clinical outcome at 5 years (event-free survival 43% and 45% in the VBT and control groups, respectively, log-rank 0.001, P = .9). CONCLUSIONS: Beta-irradiation in de novo coronary lesions significantly reduced in-stent recurrences at 6 months compared with standard procedures. However, this initial benefit was not sustained in the long term. The results of this randomized study confirm the delayed and progressive restenotic process after beta-irradiation and stent implantation in de novo lesions.
Valeria Ferrero; Flavio Ribichini; Marleen Piessens; Guy R Heyndrickx; Luc Verbeke; Bernard de Bruyne; Mauro Feola; Corrado Vassanelli; William Wijns
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  153     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-19     Completed Date:  2007-03-09     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  398-402     Citation Subset:  AIM; IM    
Department of Biomedical and Surgical Sciences, Section of Cardiology, University of Verona, Verona, Italy.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Beta Particles / therapeutic use*
Brachytherapy / methods*
Combined Modality Therapy
Coronary Angiography
Coronary Restenosis / prevention & control,  radiography
Coronary Stenosis / radiotherapy,  therapy*
Disease Progression
Follow-Up Studies
Middle Aged
Prospective Studies
Single-Blind Method
Tunica Intima / radiation effects*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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