Incidence and predictors of late recurrence after beta-radiation therapy with a 188Re-MAG3-filled balloon for diffuse in-stent restenosis.
BACKGROUND
The long-term fate of patent irradiated segments at 6 months after beta-radiation therapy has not been sufficiently evaluated.


METHODS
Two-year follow-up angiography was performed in 52 patients with patent irradiated segments at 6 months after beta-radiation with a rhenium 188-mercaptoacetyltriglycine-filled balloon for diffuse in-stent restenosis. We evaluated late recurrence (LR) and its predictors after beta-radiation.


RESULTS
Late recurrence at 2 years after radiation was observed in 10 (19.2%) of 52 patients. The minimal lumen diameter (MLD) progressively decreased, from 2.67 +/- 0.44 mm at postprocedure to 2.42 +/- 0.53 mm at 6 months to 2.09 +/- 0.75 mm at 2 years (P = .001). In the 42 patients without LR, the MLD decreased from postprocedure (2.74 +/- 0.43 mm) to 6 months (2.44 +/- 0.54 mm; P = .006), but did not change between 6 months and 2 years (2.35 +/- 0.49 mm, P = .13). In the LR group, the MLD was unchanged from postprocedure (2.33 +/- 0.29 mm) to 6 months (2.30 +/- 0.43 mm; P = .81), but decreased significantly between 6 months and 2 years (1.02 +/- 0.75 mm, P = .001). Multivariate analysis identified postprocedural MLD as an independent predictor of LR (odds ratio 0.025, 95% CI 0.007-0.94, P = .04). Late target lesion revascularization was performed in 6 patients (11.5%) between 6 months and 2 years after radiation.


CONCLUSIONS
Although LR after radiation was observed in some patients, irradiated segments remained stable for up to 2 years in most patients. Smaller postprocedural MLD, followed by delayed late loss between 6 months and 2 years, was associated with LR.
Lee
Seung-Whan
SW
Department of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
Park
Seong-Wook
SW
Hong
Myeong-Ki
MK
Kim
Young-Hak
YH
Han
Ki Hoon
KH
Kim
Jun
J
Park
Jae-Hyeong
JH
Oh
Sung-Joo
SJ
Moon
Dae Hyuk
DH
Oh
Seung Jun
SJ
Lee
Cheol Whan
CW
Kim
Jae-Joong
JJ
Park
Seung-Jung
SJ
D000800:Angioplasty, Balloon; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000453:epidemiology* / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007554:Isotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use*; D009942:Organometallic Compounds / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D012211:Rhenium / Q000627:therapeutic use*; D015607:Stents; D013997:Time Factors
D007554:Isotopes; D009842:Oligopeptides; D009942:Organometallic Compounds; C114893:rhenium-mercaptoacetyltriglycine; D012211:Rhenium