Document Detail


Intracoronary brachytherapy with beta-radiation for the treatment of long diffuse in-stent restenosis.
MedLine Citation:
PMID:  15238826     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the efficacy of intracoronary brachytherapy with beta-radiation (Sr/Y) for the treatment of long diffuse in-stent restenosis (ISR). METHODS: As recurrent ISR depends on intimal injury after coronary angioplasty, long in-stent restenotic lesions were defined as lesions with a treatment length >26 mm (lesion length >20 mm plus a treatment margin of 3 mm at each end). Seventy-eight patients with long ISR were treated at our institution with beta-brachytherapy after coronary angioplasty. Patients were irradiated with either an approximate dose of 12 Gy at 1 mm vessel wall depth or with 18 Gy at 1 mm vessel wall depth. Clinical follow-up was available for 69 patients and angiographic follow-up for 65 patients. Late lumen loss (LLL), binary restenosis (stenosis >50%), target lesion revascularization (TLR) and major adverse cardiac events (MACE) were assessed for a follow-up time of 6.6+/-2.2 months. RESULTS: Mean interventional treatment length was 46+/-18 mm. TLR was performed in all 23 patients with binary restenosis (33%). Death of cardiac cause was reported for two patients, one of whom did not undergo TLR. Thus, overall MACE rate was 35%. Recurrent ISR was significantly more frequent in patients with geographic miss. Comparison of the different radiation dose regimens revealed significantly lower LLL in patients irradiated with the higher dose (0.20+/-0.68 mm compared with 0.65+/-0.96 mm, P=0.03). CONCLUSION: Intracoronary brachytherapy with beta-radiation (Sr/Y) is a safe and effective therapeutic option for the reduction of recurrent ISR in long diffuse lesions. We recommend a high-dose irradiation with 18 Gy at 1 mm vessel wall depth.
Authors:
Christoph Schukro; Bonni Syeda; Rainer Schmid; Andreas Stemberger; Irene Lang; Michael Derntl; Thomas Neunteufl; Günter Christ; Christian Kirisits; Boris Pokrajac; Dietmar Glogar
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  15     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-07-07     Completed Date:  2006-03-17     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  285-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine II, Medical School of Vienna, Austria. christophschukro@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Beta Particles / therapeutic use
Blood Vessel Prosthesis Implantation
Brachytherapy*
Coronary Angiography
Coronary Restenosis / etiology,  radiography,  radiotherapy*
Dose-Response Relationship, Radiation
Female
Follow-Up Studies
Humans
Male
Middle Aged
Radiotherapy Dosage
Risk Factors
Stents / adverse effects*
Treatment Outcome

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


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