title: Visual assessment of procedural results following treatment with Sr-90 beta-radiation for instent restenosis.
abstract: BACKGROUND
  Visual assessment (VA) of postprocedural % diameter stenosis (DS) is used routinely in clinical practice to determine the adequacy of coronary intervention. Although VA has been shown to underestimate final %DS after balloon angioplasty compared to quantitative coronary angiography (QCA), the impact of this effect on clinical outcomes following treatment with intracoronary radiation therapy (IRT) with Sr-90 for instent restenosis (ISR) is unknown.
  
  
  METHODS
  To determine the effect of VA on the rate of major adverse cardiac events (MACEs) after IRT for ISR, we compared the clinical outcomes of 102 consecutive patients based on postprocedural %DS by QCA vs. %DS by VA. MACE was defined as death, M1 or need for target vessel revascularization (TVR).
  
  
  RESULTS
  MACE rates for the 102 consecutive patients grouped according to postprocedural %DS by QCA and VA were compared. The mean %DS by QCA was 30.7%, while the mean %DS by VA was 12.5%. The mean %DS by VA across the QCA subgroups were 13.67%, 10.71% and 13.37%, respectively (P = .244). Fifty-two patients (51.0%) had %DS > 30% by QCA with the highest MACE percentage occurring in this subgroup.
  
  
  CONCLUSIONS
  VA underestimated the %DS compared to QCA, and it was associated with worse MACE following treatment with Sr-90 for ISR.
authors.affiliation: Rush Heart Institute, Rush-Presbyterian-St. Luke's Medical Center, 1653 West Congress Parkway, Chicago, Chicago, IL 60612, USA.
authors.forename: Dave C Y
authors.initials: DC
authors.lastname: Chua
authors.forename: Francis Q
authors.initials: FQ
authors.lastname: Almeda
authors.forename: Shaun
authors.initials: S
authors.lastname: Senter
authors.forename: Susie
authors.initials: S
authors.lastname: Kim
authors.forename: David S
authors.initials: DS
authors.lastname: Bromet
authors.forename: David
authors.initials: D
authors.lastname: Butzel
authors.forename: Cam
authors.initials: C
authors.lastname: Nguyen
authors.forename: James C H
authors.initials: JC
authors.lastname: Chu
authors.forename: Clifford J
authors.initials: CJ
authors.lastname: Kavinsky
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Snell
authors.forename: Gary L
authors.initials: GL
authors.lastname: Schaer
mesh_terms: D001610:Beta Particles / Q000627:therapeutic use*; D017023:Coronary Angiography; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012086:Reoperation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013326:Strontium Radioisotopes / Q000627:therapeutic use; D015996:Survival Rate; D014796:Visual Perception
chemical_list: D013326:Strontium Radioisotopes