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Intracoronary radiation for in-stent restenosis
Current Controlled Trials in Cardiovascular Medicine volume 2, Article number: 71900 (2000)
This paper describes the three-year angiographic and clinical outcome following treatment of restenotic coronary arteries with catheter based 192Ir.
This double-blind randomised trial was undertaken to document the long-term efficacy and safety of radiation therapy.
The short-term results of radiation therapy have been promising but its long-term effect has been unknown.
At three-year follow-up target lesion revascularisation was significantly less in the 192Ir group (15.4% vs 48.3%; P <0.01). The dichotomous restenosis rate at 3 years was also significantly less in 192Ir patients (33% vs 64%; P <0.05). No events occurred at either the 6 months or 3 year follow-up to suggest an adverse effect of vascular radiotherapy.
I found this article interesting as it demonstrates a persistence of observed early clinical benefits.
Possible implications of these findings are that vascular radiotherapy may play an important role in the treatment of in-stent restenosis. A limitation of this study is its small sample size. Other studies evaluating the long-term effects of coronary radiation are pending.
A total of 55 patients were enrolled over a 9 month period; 26 were randomised to 192Ir and 29 to placebo.
Teirstein PS, Massullo V, Schatz RA, Guarneri EM, Steuterman S, Sirkin K, Cloutier DA, Leon MB, Tripuraneni P: Three-year clinical and angiographic follow-up after intracoronary radiation: results of a randomized clinical trial. Circulation. 2000, 101: 360-365.
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Malenkianpoor, M. Intracoronary radiation for in-stent restenosis. Trials 2, 71900 (2000). https://doi.org/10.1186/cvm-2001-71900
- In-stent restenosis, intracoronary radiation