A prospective single-center registry for the use of intracoronary gamma radiation in patients with diffuse in-stent restenosis

Eugenia Nikolsky, Edward Rosenblatt, Ehud Grenadier, Monther Boulos, Ariel Roguin, Chanderashekhar Patil, Zvi Bernstein, Akiva Huber, Margalit Ben-Zvi, Raquel Bar-Deroma, Walter Markiewicz, Rafael Beyar

Research output: Contribution to journalArticle

Abstract

Based on single-center prospective registry data, the study evaluates short- and longterm results of intracoronary gamma radiation in patients with diffuse in-stent restenosis in the reality of routine clinical practice. Percutaneous coronary intervention and subsequent catheter-based irradiation with iridium-192 was performed in 84 vessels (81 patients) with diffuse in-stent restenosis. Repeat coronary angiography was performed in 35 patients with clinical restenosis. With a mean follow-up of 12.0 ± 0.5 months, major adverse cardiac events were observed in 29 (34.5%) patients, including 2 cases of cardiac death, 3 myocardial infarctions, 21 target lesion revascularizations, and 4 target vessel revascularizations. Five of six patients with total occlusion of the target vessel at baseline developed target lesion restenosis. Late total occlusion of the target vessel was observed in four patients. The 1-year event-free survival rate was 69.8%. Total occlusion of the target vessel at baseline was the single independent predictor of cardiac events at 1-year follow-up (P <0.001). In patients with a target lesion in the left anterior descending artery, predictors of cardiac events also included female sex (P = 0.014), current smoking (P = 0.014), stenting during brachytherapy session (P = 0.02), and smaller reference vessel diameter at baseline (P = 0.01). The results of our registry are similar to those of randomized trials. As applied in routine clinical practice, intracoronary gamma radiation is a feasible, safe, and effective tool in the treatment of diffuse in-stent restenosis. Late events in the entire group were predicted by total occlusion at baseline.

Original languageEnglish (US)
Pages (from-to)46-52
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume56
Issue number1
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Gamma Rays
Stents
Registries
Iridium
Brachytherapy
Percutaneous Coronary Intervention
Coronary Angiography
Disease-Free Survival
Catheters
Survival Rate
Arteries
Smoking
Myocardial Infarction

Keywords

  • Brachytherapy
  • Gamma rays
  • Restenosis
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

A prospective single-center registry for the use of intracoronary gamma radiation in patients with diffuse in-stent restenosis. / Nikolsky, Eugenia; Rosenblatt, Edward; Grenadier, Ehud; Boulos, Monther; Roguin, Ariel; Patil, Chanderashekhar; Bernstein, Zvi; Huber, Akiva; Ben-Zvi, Margalit; Bar-Deroma, Raquel; Markiewicz, Walter; Beyar, Rafael.

In: Catheterization and Cardiovascular Interventions, Vol. 56, No. 1, 2002, p. 46-52.

Research output: Contribution to journalArticle

Nikolsky, E, Rosenblatt, E, Grenadier, E, Boulos, M, Roguin, A, Patil, C, Bernstein, Z, Huber, A, Ben-Zvi, M, Bar-Deroma, R, Markiewicz, W & Beyar, R 2002, 'A prospective single-center registry for the use of intracoronary gamma radiation in patients with diffuse in-stent restenosis', Catheterization and Cardiovascular Interventions, vol. 56, no. 1, pp. 46-52. https://doi.org/10.1002/ccd.10175
Nikolsky, Eugenia ; Rosenblatt, Edward ; Grenadier, Ehud ; Boulos, Monther ; Roguin, Ariel ; Patil, Chanderashekhar ; Bernstein, Zvi ; Huber, Akiva ; Ben-Zvi, Margalit ; Bar-Deroma, Raquel ; Markiewicz, Walter ; Beyar, Rafael. / A prospective single-center registry for the use of intracoronary gamma radiation in patients with diffuse in-stent restenosis. In: Catheterization and Cardiovascular Interventions. 2002 ; Vol. 56, No. 1. pp. 46-52.
@article{dc7ffa85d6f04637873fddfcfe007067,
title = "A prospective single-center registry for the use of intracoronary gamma radiation in patients with diffuse in-stent restenosis",
abstract = "Based on single-center prospective registry data, the study evaluates short- and longterm results of intracoronary gamma radiation in patients with diffuse in-stent restenosis in the reality of routine clinical practice. Percutaneous coronary intervention and subsequent catheter-based irradiation with iridium-192 was performed in 84 vessels (81 patients) with diffuse in-stent restenosis. Repeat coronary angiography was performed in 35 patients with clinical restenosis. With a mean follow-up of 12.0 ± 0.5 months, major adverse cardiac events were observed in 29 (34.5{\%}) patients, including 2 cases of cardiac death, 3 myocardial infarctions, 21 target lesion revascularizations, and 4 target vessel revascularizations. Five of six patients with total occlusion of the target vessel at baseline developed target lesion restenosis. Late total occlusion of the target vessel was observed in four patients. The 1-year event-free survival rate was 69.8{\%}. Total occlusion of the target vessel at baseline was the single independent predictor of cardiac events at 1-year follow-up (P <0.001). In patients with a target lesion in the left anterior descending artery, predictors of cardiac events also included female sex (P = 0.014), current smoking (P = 0.014), stenting during brachytherapy session (P = 0.02), and smaller reference vessel diameter at baseline (P = 0.01). The results of our registry are similar to those of randomized trials. As applied in routine clinical practice, intracoronary gamma radiation is a feasible, safe, and effective tool in the treatment of diffuse in-stent restenosis. Late events in the entire group were predicted by total occlusion at baseline.",
keywords = "Brachytherapy, Gamma rays, Restenosis, Stents",
author = "Eugenia Nikolsky and Edward Rosenblatt and Ehud Grenadier and Monther Boulos and Ariel Roguin and Chanderashekhar Patil and Zvi Bernstein and Akiva Huber and Margalit Ben-Zvi and Raquel Bar-Deroma and Walter Markiewicz and Rafael Beyar",
year = "2002",
doi = "10.1002/ccd.10175",
language = "English (US)",
volume = "56",
pages = "46--52",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",
number = "1",

}

TY - JOUR

T1 - A prospective single-center registry for the use of intracoronary gamma radiation in patients with diffuse in-stent restenosis

AU - Nikolsky, Eugenia

AU - Rosenblatt, Edward

AU - Grenadier, Ehud

AU - Boulos, Monther

AU - Roguin, Ariel

AU - Patil, Chanderashekhar

AU - Bernstein, Zvi

AU - Huber, Akiva

AU - Ben-Zvi, Margalit

AU - Bar-Deroma, Raquel

AU - Markiewicz, Walter

AU - Beyar, Rafael

PY - 2002

Y1 - 2002

N2 - Based on single-center prospective registry data, the study evaluates short- and longterm results of intracoronary gamma radiation in patients with diffuse in-stent restenosis in the reality of routine clinical practice. Percutaneous coronary intervention and subsequent catheter-based irradiation with iridium-192 was performed in 84 vessels (81 patients) with diffuse in-stent restenosis. Repeat coronary angiography was performed in 35 patients with clinical restenosis. With a mean follow-up of 12.0 ± 0.5 months, major adverse cardiac events were observed in 29 (34.5%) patients, including 2 cases of cardiac death, 3 myocardial infarctions, 21 target lesion revascularizations, and 4 target vessel revascularizations. Five of six patients with total occlusion of the target vessel at baseline developed target lesion restenosis. Late total occlusion of the target vessel was observed in four patients. The 1-year event-free survival rate was 69.8%. Total occlusion of the target vessel at baseline was the single independent predictor of cardiac events at 1-year follow-up (P <0.001). In patients with a target lesion in the left anterior descending artery, predictors of cardiac events also included female sex (P = 0.014), current smoking (P = 0.014), stenting during brachytherapy session (P = 0.02), and smaller reference vessel diameter at baseline (P = 0.01). The results of our registry are similar to those of randomized trials. As applied in routine clinical practice, intracoronary gamma radiation is a feasible, safe, and effective tool in the treatment of diffuse in-stent restenosis. Late events in the entire group were predicted by total occlusion at baseline.

AB - Based on single-center prospective registry data, the study evaluates short- and longterm results of intracoronary gamma radiation in patients with diffuse in-stent restenosis in the reality of routine clinical practice. Percutaneous coronary intervention and subsequent catheter-based irradiation with iridium-192 was performed in 84 vessels (81 patients) with diffuse in-stent restenosis. Repeat coronary angiography was performed in 35 patients with clinical restenosis. With a mean follow-up of 12.0 ± 0.5 months, major adverse cardiac events were observed in 29 (34.5%) patients, including 2 cases of cardiac death, 3 myocardial infarctions, 21 target lesion revascularizations, and 4 target vessel revascularizations. Five of six patients with total occlusion of the target vessel at baseline developed target lesion restenosis. Late total occlusion of the target vessel was observed in four patients. The 1-year event-free survival rate was 69.8%. Total occlusion of the target vessel at baseline was the single independent predictor of cardiac events at 1-year follow-up (P <0.001). In patients with a target lesion in the left anterior descending artery, predictors of cardiac events also included female sex (P = 0.014), current smoking (P = 0.014), stenting during brachytherapy session (P = 0.02), and smaller reference vessel diameter at baseline (P = 0.01). The results of our registry are similar to those of randomized trials. As applied in routine clinical practice, intracoronary gamma radiation is a feasible, safe, and effective tool in the treatment of diffuse in-stent restenosis. Late events in the entire group were predicted by total occlusion at baseline.

KW - Brachytherapy

KW - Gamma rays

KW - Restenosis

KW - Stents

UR - http://www.scopus.com/inward/record.url?scp=0036241651&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036241651&partnerID=8YFLogxK

U2 - 10.1002/ccd.10175

DO - 10.1002/ccd.10175

M3 - Article

C2 - 11979533

AN - SCOPUS:0036241651

VL - 56

SP - 46

EP - 52

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 1

ER -