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(Circulation. 2003;108:e9010.)
© 2003 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Repeating Intracoronary Radiation an Option for In-Stent Restenosis, Even After Initial Failure

Using intracoronary radiation as a repeat treatment when it is has previously failed to treat in-stent restenosis successfully is a viable option, said researchers from Washington Hospital Center in Washington, DC, in a report in this week’s issue of Circulation (Circulation. 2003;108:654–656)[Abstract/Free Full Text].

In the report led by Ron Waksman, MD, physicians followed up 51 consecutive patients for whom previous radiation treatment had failed to open stenotic areas within the stent. The patients were found to have angina. Angiography showed that they had in-stent restenosis. They were treated with percutaneous coronary intervention and radiation to the segment of the artery that had been treated with radiation previously.

The researchers treated 25 patients with gamma radiation at a dose of 15 Gy. Twenty-six patients received beta radiation with doses of between 18.3 and 23 Gy. Mean cumulative doses were 39.5 Gy (±11.9 Gy).

The outcomes of the patients were compared to those of a cohort of 299 patients for whom radiation did not work in treating in-stent stenosis and who received conventional percutaneous coronary intervention alone. At 9 months, the group that had received the repeat radiation treatment had a lower rate of repeat procedures to the coronary artery that was originally treated (23.5% in the irradiated group versus 54.6% in the percutaneous intervention alone group). The rate of major adverse heart events was also lower in the radiation treatment group (29.4% versus 61.3%). The group that had received repeat radiation had no angiographic evidence of adverse events caused . . . [Full Text of this Article]