Percutaneous interventions in radiation-associated coronary in-stent restenosis.
This study was performed to evaluate the outcome of percutaneous revascularization in "edge restenoses" developing after radioactive stent implantation in de novo and in-stent lesions. Twenty-one consecutive patients undergoing target lesion revascularization (TLR) at any follow-up after phosphorus-32 radioactive stent implantation were included in this study. We assessed the incidence of death, myocardial infarction, repeated TLR and recurrent angina over the following 18 months. After 6 months, TLR rate was 28.6%, and no stent thromboses, deaths or Q-wave myocardial infarctions occurred. Among the patients with TLR there were significantly more subjects who had received a radioactive stent in a previous in-stent restenosis (66.7% vs. 0% in patients without second restenosis; P <0.001), or who had received two radioactive stents (83.3% vs. 33.3%; P = 0.038). After 18 months, TLR rate was 33.3%, and two patients (9.5%) had died. Restenosis after intravascular radiotherapy can be safely treated by percutaneous interventional techniques, yielding an acceptable clinical result within 18 months.
Wexberg
P
P
Division of Cardiology, Department of Internal Medicine II, University of Vienna, Austria. paul.wexberg@univie.ac.at
Beran
G
G
Lang
I
I
Siostrzonek
P
P
Kirisits
C
C
Glogar
D
D
Gottsauner-Wolf
M
M
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001158:Arteries / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D001317:Austria; D019917:Blood Vessel Prosthesis Implantation; D020099:Coated Materials, Biocompatible / Q000009:adverse effects / Q000627:therapeutic use; D023903:Coronary Restenosis / Q000209:etiology* / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010761:Phosphorus Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D011827:Radiation; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use; D012086:Reoperation; D015607:Stents; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D010761:Phosphorus Radioisotopes; D019275:Radiopharmaceuticals