title: [Intracoronary beta-radiotherapy in high-risk in-stent restenosis. Prospective results of a single center registry].
abstract: BACKGROUND
  The aim of the study was to evaluate, on single center prospective data, long-term angiographic and clinical results of intracoronary beta (32P) brachytherapy in "real world" patients with high-risk in-stent restenosis lesions.
  
  
  METHODS
  Sixty-nine consecutive patients (77 lesions) with high-risk in-stent restenosis (mean lesion length 30.3 +/- 16.1 mm, pattern III-IV 57.2%, diabetes 33.3%) treated with percutaneous dilation procedures and beta-radiation therapy, underwent 7-month clinical and angiographic follow-up.
  
  
  RESULTS
  One patient (1.4%) presented with procedural non-Q wave myocardial infarction. At a mean follow-up of 7 +/- 1.5 months, death was observed in 1 patient (1.4%) and non-Q wave myocardial infarction in 3 (4.3%) (in 2 patients, who prematurely discontinued antiplatelet therapy, caused by late coronary thrombosis). Seven-month binary angiographic restenosis occurred in 20 lesions (25.9%) (in-stent restenosis 11.6%). Target lesion and target vessel revascularization occurred in 20 (28.9%) and 21 (30.4%) patients. At follow-up only 12 (17.3%) patients presented with CCS class III-IV angina. After intracoronary beta brachytherapy angiographic restenosis occurred regardless of the vessel size, lesion length and ostial location. On the contrary a high restenosis rate was documented in obstructive lesions.
  
  
  CONCLUSIONS
  As applied in routine clinical practice, radiation therapy is safe and effective in the treatment of high-risk in-stent restenosis. In spite of all that, total occlusion at baseline predicts late angiographic restenosis.
authors.affiliation: Istituto di Cardiologia Università degli Studi Policlinico S. Orsola-Malpighi Via Massarenti, 9 40138 Bologna. paortol@tin.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Ortolani
authors.forename: Antonio
authors.initials: A
authors.lastname: Marzocchi
authors.forename: William
authors.initials: W
authors.lastname: Gaiba
authors.forename: Stefano
authors.initials: S
authors.lastname: Neri
authors.forename: Cinzia
authors.initials: C
authors.lastname: Marrozzini
authors.forename: Tullio
authors.initials: T
authors.lastname: Palmerini
authors.forename: Matteo
authors.initials: M
authors.lastname: Aquilina
authors.forename: Leonardo
authors.initials: L
authors.lastname: Corlianò
authors.forename: Enzo
authors.initials: E
authors.lastname: Lombardo
authors.forename: Feisal
authors.initials: F
authors.lastname: Bunkheila
authors.forename: Stefania
authors.initials: S
authors.lastname: Pini
authors.forename: Paolo
authors.initials: P
authors.lastname: Sbarzaglia
authors.forename: Nevio
authors.initials: N
authors.lastname: Taglieri
authors.forename: Enza
authors.initials: E
authors.lastname: Barbieri
authors.forename: Angelo
authors.initials: A
authors.lastname: Branzi
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001610:Beta Particles / Q000627:therapeutic use; D001918:Brachytherapy / Q000379:methods*; D023903:Coronary Restenosis / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010761:Phosphorus Radioisotopes; D011446:Prospective Studies; D012189:Retrospective Studies; D015607:Stents
chemical_list: D010761:Phosphorus Radioisotopes