title: Routine intracoronary beta-irradiation. Acute and one year outcome in patients at high risk for recurrence of stenosis.
abstract: OBJECTIVE
  Intracoronary radiation is a promising therapy potentially reducing restenosis following catheter-based interventions. Currently, only limited data on this treatment are available. The feasibility and outcome in daily routine practice, however, is unknown.
  
  
  RESULTS
  In 100 consecutive patients, intracoronary beta-radiation was performed with a (90)Strontium system (Novoste Beta-Cathtrade mark) following angioplasty. Predominantly complex (73% type B2 and C) and long lesions (length 24.3+/-15.3 mm) were included (37% de novo, 19% restenotic and 44% in-stent restenotic lesions). Radiation success was 100%. Mean prescribed dose was 19.8+/-2.5 Gy. A pullback procedure was performed in 19% lesions. Geographic miss occurred in 8% lesions. Periprocedural thrombus formation occurred in four lesions, dissection in nine lesions. During hospital stay, no death, acute myocardial infarction, or repeat revascularization was observed. Major adverse cardiac events occurred predominantly between 6 and 12 months after the index procedure with major adverse cardiac event-free survival of 66% at 12 months (one death, 10 Q-wave myocardial infarctions, 23 target vessel revascularizations; ranked for worst event).
  
  
  CONCLUSIONS
  Routine catheter-based intracoronary beta-radiation therapy after angioplasty is safe and feasible with a high acute procedural success. The clinical 1-year follow-up showed delayed occurrence of major adverse cardiac events between 6 and 12 months after the index procedure.
authors.affiliation: Department for Cardiology, Thoraxcenter, University Hospital Rotterdam, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Regar
authors.forename: K
authors.initials: K
authors.lastname: Kozuma
authors.forename: G
authors.initials: G
authors.lastname: Sianos
authors.forename: V L M A
authors.initials: VL
authors.lastname: Coen
authors.forename: W J
authors.initials: WJ
authors.lastname: van der Giessen
authors.forename: D
authors.initials: D
authors.lastname: Foley
authors.forename: P
authors.initials: P
authors.lastname: de Feyter
authors.forename: B
authors.initials: B
authors.lastname: Rensing
authors.forename: P
authors.initials: P
authors.lastname: Smits
authors.forename: J
authors.initials: J
authors.lastname: Vos
authors.forename: A H M
authors.initials: AH
authors.lastname: Knook
authors.forename: A J
authors.initials: AJ
authors.lastname: Wardeh
authors.forename: P C
authors.initials: PC
authors.lastname: Levendag
authors.forename: P W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001610:Beta Particles / Q000627:therapeutic use; D001918:Brachytherapy / Q000379:methods*; D023903:Coronary Restenosis / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013326:Strontium Radioisotopes / Q000627:therapeutic use
chemical_list: D013326:Strontium Radioisotopes