Document Detail


Radiation following percutaneous balloon aortic valvuloplasty to prevent restenosis (RADAR pilot trial).
MedLine Citation:
PMID:  16810699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We wished to determine the feasibility and early safety of external beam radiation therapy (EBRT) used following balloon aortic valvuloplasty (BAV) to prevent restenosis.
BACKGROUND: BAV for calcific aortic stenosis (AS) has been largely abandoned because of high restenosis rates, i.e., > 80% at 1 year. Radiation therapy is useful in preventing restenosis following vascular interventions and treating other benign noncardiovascular disorders.
METHODS: We conducted a 20-patient, pilot study evaluating EBRT to prevent restenosis following BAV in elderly patients with calcific AS. Total doses ranging from 12-18 Gy were delivered in fractions over a 3-5 day post-op period to the aortic valve. Echocardiography was performed pre and 2 days post-op, 1, 6, and 12 months following BAV.
RESULTS: One-year follow-up is completed (age 89 +/- 4). There were no complications related to EBRT. Eight patients died prior to 1 year; 5 of 10 (50%) in the low-dose (12 Gy) group and 3 of 10 (30%) in the high-dose (15-18 Gy) group. None of these 8 patients had restenosis, i.e., > 50% loss of the initial AVA gain, and only three deaths were cardiac in origin. One patient underwent aortic valve replacement and none repeated BAV. By 1 year, 3 of the initial 10 (30%) in the low-dose group and 1 of 9 (11%) in the high-dose group demonstrated restenosis (21% overall).
CONCLUSIONS: EBRT following BAV in elderly patients with AS is feasible, free of early complications, and holds promise in reducing the 1 year restenosis rate in a dose-dependent fashion.
Authors:
Wes R Pedersen; Robert A Van Tassel; Talia A Pierce; David M Pence; David J Monyak; Tae H Kim; Kevin M Harris; Thomas Knickelbine; John R Lesser; James D Madison; Michael R Mooney; Irvin F Goldenberg; Terrence F Longe; Anil K Poulose; Kevin J Graham; Richard R Nelson; Marc R Pritzker; Luis A Pagan-Carlo; Charlene R Boisjolie; Andrey G Zenovich; Robert S Schwartz
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  68     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-28     Completed Date:  2007-01-19     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  183-92     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Aorta / radiation effects
Aortic Valve Stenosis / physiopathology,  prevention & control*,  therapy
Brachytherapy*
Catheterization*
Combined Modality Therapy
Female
Humans
Male
Pilot Projects
Prospective Studies
Radiotherapy / methods
Radiotherapy Dosage
Recurrence

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


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