Beta-radiation for coronary in-stent restenosis.

Latchem DR; Urban P; Goy JJ; De Benedetti E; Pica A; Coucke P; Eeckhout E

doi:10.1002/1522-726x(200012)51:4<422::aid-ccd10>3.0.co;2-a

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Journal article

Beta-radiation for coronary in-stent restenosis.

Latchem DR Divisions of Cardiology and Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Urban P
Goy JJ
De Benedetti E
Pica A
Coucke P
Eeckhout E

2000-12-07

Published in:

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. - 2000

Angioplasty, Balloon, Coronary

English To determine the feasibility and safety of an intracoronary beta-radiation device in preventing the recurrence of in-stent restenosis (ISR) after successful angioplasty, we studied 37 patients treated with beta-radiation (30-mm strontium-90 source) after angioplasty. The mean reference diameter was 2.9 +/- 0.5 mm, and 62% of lesions were diffuse, including four total occlusions. Beta-radiation was successfully delivered in 36 of 37 (97%) cases. Over the course of 7.1 +/- 4.5 mo follow-up, there were no myocardial infarctions and three deaths: one from preexisting malignancy, one from progressive cardiac failure, and one from sudden cardiac death. Target vessel revascularization (TVR) was performed in seven of 36 (19%) patients. Thirty patients underwent angiography at 6 mo; three (10%) experienced restenosis (diameter stenosis > 50%) at the target site, four (13%) had edge stenoses, and two (7%) had late (> 1 mo) thrombotic occlusions. Beta-radiation for ISR is associated with encouragingly low rates of target lesion restenosis and TVR. Further improvements are needed to solve the limitations of the edge effect and late occlusion.

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