Three-year clinical follow-up after strontium-90/yttrium-90 beta-irradiation for the treatment of in-stent coronary restenosis.
Because late vessel failure has been speculated as a possible limitation of vascular brachytherapy, we conducted a prospective clinical evaluation at 6, 12, 24, and 36 months of follow-up after irradiation with strontium-90/yttrium-90 for in-stent restenosis, regardless of the patient's symptomatic status. We report complete 3-year follow-up data for 106 consecutive patients. The cumulative rate of death at 6, 12, 24, and 36 months was 0.9%, 0.9%, 0.9%, and 1.9% respectively. The corresponding rates for acute ST-elevation myocardial infarction were 2.8%, 4.7%, 4.7%, and 4.7%, respectively. The cumulative rate of late thrombotic occlusion at 6, 12, 24, and 36 months was 3.8%, 4.7%, 4.7%, and 4.7%, respectively. The corresponding rates of target lesion revascularization and target vessel revascularization were 8.5% and 12.3% (p = 0.046), 14.2% (p = 0.157) and 18.0% (p = 0.046), 12.3% and 18.9% (p = 0.008), and 21.7% (p = 0.083) and 29.2% (p = 0.005), respectively. The cumulative rate of all major adverse cardiovascular events at 6, 12, 24, and 36 months was 16.1%, 24.5% (p = 0.003), 27.4% (p = 0.083), and 35.8% (p = 0.003), respectively. In conclusion, these results indicate a delayed and, even in the third year after the index procedure, continued restenotic process after beta irradiation of in-stent restenotic lesions.
Baierl
Verena
V
Division of Cardiology, Department of Medicine, Medizinische Klinik und Poliklinik, University Hospital Campus Innenstadt, Munich, Germany.
Baumgartner
Simone
S
Pöllinger
Barbara
B
Leibig
Marcus
M
Rieber
Johannes
J
König
Andreas
A
Krötz
Florian
F
Sohn
Hae-Young
HY
Siebert
Uwe
U
Haimerl
Wolfgang
W
Dühmke
Eckhart
E
Theisen
Karl
K
Klauss
Volker
V
Schiele
Thomas M
TM
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D001918:Brachytherapy; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D015607:Stents; D013326:Strontium Radioisotopes / Q000627:therapeutic use; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
D019275:Radiopharmaceuticals; D013326:Strontium Radioisotopes; D015021:Yttrium Radioisotopes