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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2004-12-7
pubmed:abstractText
The objective of this study was to determine the safety and efficacy of (32)P beta-brachytherapy in totally occlusive in-stent restenosis (ISR). Patients with occlusive ISR were generally excluded from the randomized clinical trials on intracoronary brachytherapy (utilizing either gamma- or beta-sources) that have shown reductions in restenosis rate and need for revascularization procedures. We analyzed short- and long-term effects of (32)P beta-brachytherapy (20 Gy) in 27 patients (28 lesions) with occlusive ISR and 84 (99 lesions) patients with nonocclusive high-risk ISR. The primary outcome measure was frequency of in-lesion angiographic binary restenosis at 7 months. Secondary endpoints were rates of major adverse cardiac events (MACE), target vessel revascularization (TVR), clinically driven TVR, and target lesion revascularization (TLR). (32)P beta-brachytherapy was feasible and safe and provided similar postprocedural angiographic results in the two clinically comparable groups. However, the 7-month binary restenosis rate was higher in the occlusive group, as were the MACE and late total occlusion rates. Multivariate logistic analysis of the overall population indicated occlusive pattern to be the only independent predictor of angiographic restenosis. In both groups, recurrent lesions most often showed a focal pattern with significant reduction of length. Although safe and effective in high-risk ISR, (32)P brachytherapy at 20 Gy does not appear to be sufficient to avoid long-term restenosis in patients with occlusive lesions. Further studies should determine the most suitable source and dosage of brachytherapy for patients with occlusive ISR.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
1522-1946
pubmed:author
pubmed:copyrightInfo
(c) 2004 Wiley-Liss, Inc.
pubmed:issnType
Print
pubmed:volume
63
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
433-8
pubmed:dateRevised
2009-11-19
pubmed:meshHeading
pubmed-meshheading:15558757-Aged, pubmed-meshheading:15558757-Beta Particles, pubmed-meshheading:15558757-Blood Vessel Prosthesis Implantation, pubmed-meshheading:15558757-Brachytherapy, pubmed-meshheading:15558757-Coronary Angiography, pubmed-meshheading:15558757-Coronary Restenosis, pubmed-meshheading:15558757-Female, pubmed-meshheading:15558757-Follow-Up Studies, pubmed-meshheading:15558757-Humans, pubmed-meshheading:15558757-Male, pubmed-meshheading:15558757-Middle Aged, pubmed-meshheading:15558757-Multivariate Analysis, pubmed-meshheading:15558757-Phosphorus Radioisotopes, pubmed-meshheading:15558757-Prospective Studies, pubmed-meshheading:15558757-Radiopharmaceuticals, pubmed-meshheading:15558757-Stents, pubmed-meshheading:15558757-Time Factors, pubmed-meshheading:15558757-Treatment Outcome
pubmed:year
2004
pubmed:articleTitle
Long-term clinical and angiographic outcome of patients with occlusive in-stent restenosis treated with (32P) beta-brachytherapy.
pubmed:affiliation
Institute of Cardiology, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. paortol@tin.it
pubmed:publicationType
Journal Article