| Intracoronary brachytherapy with beta-radiation for the treatment of long diffuse in-stent restenosis. | |
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MedLine Citation:
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PMID: 15238826 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Clinical Trial; Comparative Study; Journal Article |
Journal Detail:
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Title: Coronary artery disease Volume: 15 ISSN: 0954-6928 ISO Abbreviation: Coron. Artery Dis. Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-07-07 Completed Date: 2006-03-17 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: England |
Other Details:
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Languages: eng Pagination: 285-9 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine II, Medical School of Vienna, Austria. christophschukro@hotmail.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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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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