title: Five-year follow-up after intracoronary gamma radiation therapy for in-stent restenosis.
abstract: BACKGROUND
  The Washington Radiation for In-Stent Restenosis Trial is a double-blinded randomized study evaluating the effects of intracoronary radiation therapy (IRT) in patients with in-stent restenosis (ISR).
  
  
  RESULTS
  One hundred thirty patients with ISR (100 native coronary and 30 vein grafts) underwent percutaneous transluminal coronary angioplasty, laser ablation, rotational atherectomy, or additional stenting (36% of lesions). Patients were randomized to either 192-Iridium IRT or placebo, with a prescribed dose of 15 Gy to a 2-mm radial distance from the center of the source. Angiographic restenosis (27% versus 56%, P=0.002) and target vessel revascularization (26% versus 68%, P<0.001) were reduced at 6 months in patients treated with IRT. Between 6 and 60 months, patients treated with IRT compared with placebo had more target lesion revascularization (IRT, 21.6% versus placebo, 4.7%; P=0.04) and target vessel revascularization (IRT, 21.5% versus placebo, 6.1%; P=0.03). At 5 years, the major adverse cardiac event rate was significantly reduced with IRT (46.2% versus 69.2%, P=0.008).
  
  
  CONCLUSIONS
  In the Washington Radiation for In-Stent Restenosis Trial, patients with ISR treated with IRT using 192-Iridium had a reduction in the need for repeat target lesion and vessel revascularization at 6 months and 5 years.
authors.affiliation: Washington Hospital Center, 110 Irving St NW, Suite 4B-1, Washington, DC 20010, USA. ron.waksman@medstar.net
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Ajani
authors.forename: R Lawrence
authors.initials: RL
authors.lastname: White
authors.forename: Rosanna
authors.initials: R
authors.lastname: Chan
authors.forename: Bill
authors.initials: B
authors.lastname: Bass
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Kent
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Regina
authors.initials: R
authors.lastname: Deible
authors.forename: Ellen
authors.initials: E
authors.lastname: Pinnow
authors.forename: Joseph
authors.initials: J
authors.lastname: Lindsay
mesh_terms: D006328:Cardiac Catheterization; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis / Q000209:etiology / Q000532:radiotherapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005720:Gamma Rays / Q000009:adverse effects / Q000627:therapeutic use*; D006321:Heart / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects*; D013927:Thrombosis / Q000453:epidemiology