Keywords :
Stent; Vascular disease; Coronary heart disease; Cardiovascular disease; Arterial disease; Radiotherapy; Instrumentation therapy; Prognosis; Recurrence; Prevention; Treatment efficiency; Beta irradiation; Treatment; Human; Coronary artery; Restenosis; Complication; Endoprosthesis; Vaisseau sanguin pathologie; Cardiopathie coronaire; Radiothérapie; Artère pathologie; Appareil circulatoire pathologie; Récurrence; Pronostic; Traitement instrumental; Irradiation bêta; Efficacité traitement; Prévention; Artère coronaire; Homme; Traitement; Resténose; Endoprothèse
Abstract :
[en] 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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