Successful reduction of in-stent restenosis in long lesions using beta-radiation--subanalysis from the RENO registry

Details

Serval ID
serval:BIB_B92D11724518
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Successful reduction of in-stent restenosis in long lesions using beta-radiation--subanalysis from the RENO registry
Journal
International Journal of Radiation Oncology, Biology, Physics
Author(s)
Baumgart  D., Bonan  R., Naber  C., Serruys  P., Colombo  A., Silber  S., Eeckhout  E., Urban  P.
ISSN
0360-3016 (Print)
Publication state
Published
Issued date
03/2004
Volume
58
Number
3
Pages
817-27
Notes
Evaluation Studies
Journal Article
Multicenter Study --- Old month value: Mar 1
Abstract
PURPOSE: Long lesions remain a challenging task in interventional cardiology, with a high propensity of restenosis, especially within the stented segment. Although intracoronary gamma-radiation has been proved to reduce diffuse in-stent restenosis in long lesions, such an effect remains to be determined using beta-radiation. METHODS AND MATERIALS: Of 1098 consecutive patients at 46 European centers treated with localized beta-radiation ((90)Sr, Novoste Beta-Cath System), 139 patients (mean age 61.5 +/- 10.7 years, 84% male, 22% with diabetes mellitus) with lesions treated using a >40-mm source length underwent radiation using a single 60-mm source train (34%) or a stepping/pullback procedure with a 30-mm (12%) or 40-mm (87%) source length after conventional interventional procedures. The mean lesion length was 35.3 +/- 17.9 mm. RESULTS: Technical success was achieved in 96% of cases. Geographic miss was noted in 9 patients (6.5%). The reference (placebo) group was obtained from the Washington Hospital Center for In-Stent Restenosis Trial (WRIST) and the WRIST Trial for long lesions (LONG WRIST) studies by selecting the cases (94 patients) that required a dummy source length >/=13 seeds (or >51 mm in length). Statistically significant improvement was noted in late angiographic restenosis (34.7% vs. 76.5%, p <0.0001), target vessel revascularization (14.9% vs. 60.6), and major adverse cardiac events (i.e., death, myocardial infarction, or total vessel revascularization) (17.9% vs. 64.9%, p <0.0001) at 6 months in reference to the nonradiation group. CONCLUSION: This subanalysis from the Radiation in Europe with Novoste study confirms the safety and efficacy of beta-radiation combined with conventional interventional procedures in patients with diffuse, long, in-stent restenosis
Keywords
Aged Beta Rays/adverse effects/*therapeutic use Coronary Restenosis/pathology/*radiotherapy Europe Female Humans Middle Aged Registries *Stents
Pubmed
Web of science
Create date
28/01/2008 9:51
Last modification date
20/08/2019 15:27
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