title: Endovascular beta-radiation to reduce restenosis after coronary balloon angioplasty: results of the beta energy restenosis trial (BERT).
abstract: BACKGROUND
  In the porcine overstretch injury model of restenosis, endovascular beta-radiation reduces neointima formation. To determine whether this therapy could be applied to patients with coronary artery disease, a special device was developed to allow delivery of 12 encapsulated 90Sr/Y sources, measuring a total of 30 mm, to various sites within the coronary arterial tree. This study was designed to evaluate the feasibility of the delivery of 12, 14, or 16 Gy at 2 mm after balloon angioplasty of stenoses of native coronary vessels.
  
  
  RESULTS
  Delivery of beta-radiation was attempted in 23 patients after successful balloon angioplasty. Source delivery was successful in 21 of the 23 patients (91%). There was no in-hospital or 30-day morbidity or mortality. Follow-up quantitative coronary arteriography in 20 patients demonstrated a late loss of 0.05 mm, a late loss index of 4%, and a restenosis rate of 15%. The use of the beta-emitter 90Sr/Y significantly reduced treatment time and operator exposure compared with previous trials with the gamma-emitter 192Ir.
  
  
  CONCLUSIONS
  In this study, the administration of endovascular beta-radiation after angioplasty was safe and feasible and substantially altered the postangioplasty late lumen loss, resulting in a lower-than-expected rate of restenosis. On the basis of these encouraging results, a multicenter, randomized trial with operators and patients blinded to treatment assignment is planned.
authors.affiliation: Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA. sking01@emory.edu
authors.forename: S B
authors.initials: SB
authors.lastname: King
authors.forename: D O
authors.initials: DO
authors.lastname: Williams
authors.forename: P
authors.initials: P
authors.lastname: Chougule
authors.forename: J L
authors.initials: JL
authors.lastname: Klein
authors.forename: R
authors.initials: R
authors.lastname: Waksman
authors.forename: R
authors.initials: R
authors.lastname: Hilstead
authors.forename: J
authors.initials: J
authors.lastname: Macdonald
authors.forename: K
authors.initials: K
authors.lastname: Anderberg
authors.forename: I R
authors.initials: IR
authors.lastname: Crocker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001610:Beta Particles; D001918:Brachytherapy; D003327:Coronary Disease / Q000517:prevention & control*; D003331:Coronary Vessels / Q000528:radiation effects*; D006801:Humans; D008875:Middle Aged; D012008:Recurrence