Document Detail


Three-year follow-up after intracoronary gamma radiation therapy for in-stent restenosis. Original WRIST. Washington Radiation for In-Stent Restenosis Trial.
MedLine Citation:
PMID:  12160759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Washington Radiation for In-Stent Restenosis Trial (WRIST) is a double-blinded randomized study evaluating the effects of intracoronary radiation therapy (IRT) in patients with in-stent restenosis (ISR). METHODS: One hundred and thirty patients with ISR (100 native coronary and 30 vein grafts) underwent PTCA, laser ablation, rotational atherectomy, and/or additional stenting (36% of lesions). Patients were randomized to either Iridium-192 IRT or placebo, with a prescribed dose of 15 Gy to a 2-mm radial distance from the center of the source. RESULTS: Angiographic restenosis (27% vs. 56%, P=.002) and target vessel revascularization (TVR; 26% vs. 66%, P<.001) were dramatically reduced at 6 months in IRT patients. Between 6 and 36 months, IRT compared to placebo patients had more target lesion revascularization (TLR; IRT=17% vs. placebo=2%, P=.002) and TVR (IRT=17% vs. placebo=3%, P=.009). At 3 years, the major adverse cardiac event (MACE) rate was significantly reduced with IRT (39% vs. 65%, P=.003). CONCLUSIONS: In WRIST, patients with ISR treated with IRT using 192Ir had a marked reduction in the need for repeat target lesion and vessel revascularization at 6 months, with the clinical benefit maintained at 3 years.
Authors:
A E Ajani; R Waksman; A K Sharma; D H Cha; E Cheneau; R L White; D Canos; A D Pichard; L F Satler; K M Kent; E Pinnow; J Lindsay
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cardiovascular radiation medicine     Volume:  2     ISSN:  1522-1865     ISO Abbreviation:  Cardiovasc. Radiat. Med.     Publication Date:    2001 Oct-Dec
Date Detail:
Created Date:  2002-08-05     Completed Date:  2002-10-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100888865     Medline TA:  Cardiovasc Radiat Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  200-4     Citation Subset:  IM    
Affiliation:
Washington Hospital Center and Washington Cancer Institute at the Washington Hospital Center, Washington, DC 20010, USA.
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MeSH Terms
Descriptor/Qualifier:
Brachytherapy
Coronary Restenosis / radiotherapy*
Coronary Stenosis / therapy
Double-Blind Method
Female
Follow-Up Studies
Humans
Iridium Radioisotopes / therapeutic use
Male
Middle Aged
Prospective Studies
Radiotherapy Dosage
Stents*
Time Factors
Chemical
Reg. No./Substance:
0/Iridium Radioisotopes

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


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