Clinical outcomes of patients treated with the cutting balloon and Sr-90 beta-irradiation for instent restenosis.
BACKGROUND
The cutting balloon (CB) is an emerging therapy for the treatment of instent restenosis (ISR), but its impact on the clinical outcomes of patients treated with intracoronary radiation therapy (IRT) with Sr-90 compared with conventional PTCA and IRT is not clearly defined.


METHODS
We compared the baseline demographics, angiographic characteristics and clinical outcomes of 102 consecutive patients with ISR treated either with CB+IRT (n=45) or with conventional PTCA+IRT (n=57). The combined endpoint was the occurrence of major adverse cardiac events (MACE), which was defined as a composite of death, myocardial infarction (MI) or target vessel revascularization (TVR) at 6 months.


RESULTS
The CB+IRT group had a shorter mean lesion length (14.3+/-6.5 vs. 21.1+/-15.7, P=.009), and greater utilization of glycoprotein IIb/IIIa inhibitors during the procedure (48.9% vs. 26.3%, P=.02) compared to the PTCA+IRT group. There were no significant differences in the baseline demographics, angiographic and procedural results, or subsequent MACE at 6 months between the two groups.


CONCLUSIONS
The strategy of CB+IRT using Sr-90 for ISR is associated with similar procedural and clinical outcomes compared to conventional PTCA+IRT. Further study is warranted to determine which patient subgroups would derive the most benefit from this approach.
Almeda
Francis Q
FQ
Rush Heart Institute, Rush-Presbyterian-St. Luke's Medical Center, 1021 Jelke, 1653 W. Congress Parkway, Chicago, IL 60612, USA. francis_q_almeda@rush.edu
Chua
David Y
DY
Nathan
Sandeep
S
Kim
Susie
S
Meyer
Peter M
PM
Thew
Stephen T
ST
Nguyen
Cam
C
Chu
James C H
JC
Kavinsky
Clifford J
CJ
Schaer
Gary L
GL
Snell
R Jeffrey
RJ
D000368:Aged; D000800:Angioplasty, Balloon; D001610:Beta Particles / Q000627:therapeutic use*; D019917:Blood Vessel Prosthesis Implantation; D002986:Clinical Trials as Topic; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000627:therapeutic use; D011446:Prospective Studies; D011897:Random Allocation; D015607:Stents / Q000009:adverse effects; D013326:Strontium Radioisotopes / Q000627:therapeutic use*; D016896:Treatment Outcome
D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D013326:Strontium Radioisotopes