title: Five-year clinical and angiographic follow-up after intracoronary iridium-192 radiation therapy.
abstract: BACKGROUND
  Ionizing gamma radiation has been shown to reduce neointimal formation and the incidence of restenosis after balloon angioplasty and stenting in clinical trials. However, the long-term effects of this therapy are unknown. The first cohort of patients to receive intracoronary gamma radiation after balloon angioplasty for the prevention of restenosis have completed a 5-year angiographic and clinical follow-up. The outcome of these patients is presented and discussed.
  
  
  METHODS
  Twenty-one patients with unstable angina (22 arteries) underwent standard balloon angioplasty. Intracoronary radiation therapy was performed immediately after the intervention using an Iridium-192 source wire hand-delivered to the angioplasty site. All patients were followed clinically and Quantitative Coronary Analysis (QCA) was performed at 6, 24, 36 and 60 months.
  
  
  RESULTS
  Target lesion revascularization occurred in six lesions, three of which were total occlusions (two early within 30 days and one occurred at 2 years), and one patient had a myocardial infarction attributable to a nontarget vessel. Serial QCA detected a binary restenosis rate of 28.6% (n=6) at 6 months. The late loss (0.29 mm) and loss index (0.25) remained low at 2, 3 and 5 years. Angiographic complications included four aneurysms (two procedure related and two occurring within 3 months). At 2 years, only one aneurysm increased in size (46 vs. 27 mm(2)); and at 3 and 5 years, all aneurysms remained unchanged. No other angiographic complications were observed.
  
  
  CONCLUSIONS
  The early clinical and angiographic effects of intracoronary gamma radiation were maintained at 5 years without further increase in the aneurysm formation or apparent new adverse effects related to the radiation therapy between 2 and 5 years.
authors.affiliation: Department of Cardiology Hospital Miguel Perez-Carreno, Centro Medico, Caracas, Venezuela.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Condado
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
authors.forename: Jorge F
authors.initials: JF
authors.lastname: Saucedo
authors.forename: Balram
authors.initials: B
authors.lastname: Bhargava
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Lansky
authors.forename: Carlos
authors.initials: C
authors.lastname: Calderas
authors.forename: Orlando
authors.initials: O
authors.lastname: Gurdiel
authors.forename: Juan
authors.initials: J
authors.lastname: Gonzalez
authors.forename: Merche
authors.initials: M
authors.lastname: Fadoul
authors.forename: Bogart
authors.initials: B
authors.lastname: Parra
authors.forename: Isabel
authors.initials: I
authors.lastname: Iturria
authors.forename: Bingen
authors.initials: B
authors.lastname: Amezaga
mesh_terms: D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015331:Cohort Studies; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007322:Instillation, Drug; D007496:Iridium Radioisotopes / Q000008:administration & dosage* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D015996:Survival Rate; D013997:Time Factors
chemical_list: D007496:Iridium Radioisotopes