Literature DB >> 12748220

Clinical and angiographic acute and follow up results of intracoronary beta brachytherapy in saphenous vein bypass grafts: a subgroup analysis of the multicentre European registry of intraluminal coronary beta brachytherapy (RENO).

T M Schiele1, E Regar, S Silber, E Eeckhout, D Baumgart, W Wijns, A Colombo, W Rutsch, D Meerkin, A Gershlick, R Bonan, P Urban.   

Abstract

OBJECTIVE: To assess clinically and angiographically the feasibility, safety, and effectiveness of vascular brachytherapy (VBT) in saphenous vein bypass grafts (SVG). PATIENTS AND METHODS: 67 of 1098 (6.1%) consecutive patients of the European registry of intraluminal coronary beta brachytherapy underwent treatment for 68 SVG lesions by VBT using a Sr/Y(90) source train (BetaCath). Clinical follow up data were obtained for all of them after a mean (SD) of 6.3 (2.4) months and angiographic follow up was performed in 61 patients (91.0%) after 6.9 (2.0) months.
RESULTS: 58 (86.6%) patients were men, their mean (SD) age was 66 (10) years, 28 (41.8%) had unstable angina, and 21 (31.3%) had diabetes. Fifty three (77.9%) lesions were in-stent restenosis, 13 (19.1%) de novo lesions, and 2 (3.0%) non-stented restenotic lesions. Mean (SD) reference diameter before the intervention was 4.19 (0.52) mm, mean (SD) lesion length was 23.56 (20.38) mm, and mean (SD) minimum lumen diameter measured 0.73 (0.62) mm. Mean (SD) acute gain was 3.02 (0.88) mm. The prescribed radiation dose was 20.1 (3.2) Gy. Pullback manoeuvres were performed in 17 (25.0%) of cases. Most patients received combined aspirin and thienopyridin treatment for 6 or 12 months after the procedure. Technical success was obtained in 62 (91.2%) treated lesions and in-hospital major adverse cardiac events occurred in 4.5%. At follow up, mean (SD) reference diameter was 4.20 (0.53) mm, minimum lumen diameter 2.94 (1.50) mm, and late loss 0.86 (1.25) mm. The overall major adverse cardiac events rate was 26.7%.
CONCLUSION: VBT of SVG is feasible and safe. At follow up the reintervention rate and cardiac morbidity and mortality seem to be favourable, considering that interventions in SVG usually are associated with the highest risks.

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Year:  2003        PMID: 12748220      PMCID: PMC1767684          DOI: 10.1136/heart.89.6.640

Source DB:  PubMed          Journal:  Heart        ISSN: 1355-6037            Impact factor:   5.994


  25 in total

1.  Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis.

Authors:  R Waksman; R L White; R C Chan; B G Bass; L Geirlach; G S Mintz; L F Satler; R Mehran; P W Serruys; A J Lansky; P Fitzgerald; B Bhargava; K M Kent; A D Pichard; M B Leon
Journal:  Circulation       Date:  2000-05-09       Impact factor: 29.690

2.  Inhibition of restenosis with beta-emitting radiotherapy: Report of the Proliferation Reduction with Vascular Energy Trial (PREVENT).

Authors:  A E Raizner; S N Oesterle; R Waksman; P W Serruys; A Colombo; Y L Lim; A C Yeung; W J van der Giessen; L Vandertie; J K Chiu; L R White; P J Fitzgerald; G L Kaluza; N M Ali
Journal:  Circulation       Date:  2000-08-29       Impact factor: 29.690

3.  Stenting of venous bypass grafts: a new treatment modality for patients who are poor candidates for reintervention.

Authors:  I K de Scheerder; B H Strauss; P J de Feyter; K J Beatt; L H Baur; W Wijns; G R Heyndrix; H Suryapranata; M van den Brand; B Buis
Journal:  Am Heart J       Date:  1992-04       Impact factor: 4.749

4.  Comparison of stenting and balloon angioplasty for narrowings in aortocoronary saphenous vein conduits in place for more than five years.

Authors:  S J Brener; S G Ellis; C Apperson-Hansen; M B Leon; E J Topol
Journal:  Am J Cardiol       Date:  1997-01-01       Impact factor: 2.778

5.  Catheter-based radiotherapy to inhibit restenosis after coronary stenting.

Authors:  P S Teirstein; V Massullo; S Jani; J J Popma; G S Mintz; R J Russo; R A Schatz; E M Guarneri; S Steuterman; N B Morris; M B Leon; P Tripuraneni
Journal:  N Engl J Med       Date:  1997-06-12       Impact factor: 91.245

6.  A multicenter, randomized trial of coronary angioplasty versus directional atherectomy for patients with saphenous vein bypass graft lesions. CAVEAT-II Investigators.

Authors:  D R Holmes; E J Topol; R M Califf; L G Berdan; F Leya; P B Berger; P L Whitlow; R D Safian; A G Adelman; M A Kellett
Journal:  Circulation       Date:  1995-04-01       Impact factor: 29.690

7.  Late total occlusion after intracoronary brachytherapy for patients with in-stent restenosis.

Authors:  R Waksman; B Bhargava; G S Mintz; R Mehran; A J Lansky; L F Satler; A D Pichard; K M Kent; M B Leon
Journal:  J Am Coll Cardiol       Date:  2000-07       Impact factor: 24.094

8.  Stent placement compared with balloon angioplasty for obstructed coronary bypass grafts. Saphenous Vein De Novo Trial Investigators.

Authors:  M P Savage; J S Douglas; D L Fischman; C J Pepine; S B King; J A Werner; S R Bailey; P A Overlie; S H Fenton; J A Brinker; M B Leon; S Goldberg
Journal:  N Engl J Med       Date:  1997-09-11       Impact factor: 91.245

Review 9.  Balloon angioplasty for the treatment of lesions in saphenous vein bypass grafts.

Authors:  P J de Feyter; R J van Suylen; P P de Jaegere; E J Topol; P W Serruys
Journal:  J Am Coll Cardiol       Date:  1993-06       Impact factor: 24.094

10.  Early and late quantitative angiographic results of vein graft lesions treated by excimer laser with adjunctive balloon angioplasty.

Authors:  B H Strauss; M K Natarajan; W B Batchelor; D E Yardley; J A Bittl; T A Sanborn; J A Power; L E Watson; R Moothart; J E Tcheng
Journal:  Circulation       Date:  1995-08-01       Impact factor: 29.690

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  1 in total

Review 1.  Current understanding of coronary in-stent restenosis. Pathophysiology, clinical presentation, diagnostic work-up, and management.

Authors:  T M Schiele
Journal:  Z Kardiol       Date:  2005-11
  1 in total

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