Korean Circ J.  2003 Mar;33(3):176-182. 10.4070/kcj.2003.33.3.176.

Intravascular Ultrasound Analysis of Nonstented Adjacent Segments in Diffuse In-stent Restenosis Treated with Radiation Therapy with a Rhenium-188-Filled Balloon

Affiliations
  • 1Department of Internal Medicine, Cheong Ju St. Mary's Hospital, Cheongju, Korea.
  • 2Department of Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 3Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Intracoronary stenting now constitute the majority of coronary interventions, and subsequently in-stent restenosis has become a significant clinical problem. Recently, several studies on intracoronary radiation therapy, in patients with in-stent restenosis, have demonstrated a reduction in binary angiographic restenosis and target lesion revascularization compared with control groups. The effects of beta-radiation therapy on non-stented adjacent segments in in-stent restenosis have not been sufficiently evaluated. beta-radiation therapy for in-stent restenosis was performed with a 188Re-MAG3 filled balloon.
SUBJECTS AND METHODS
We evaluated, and compared, the effects of beta-radiation therapy on non-stented adjacent segments, in in-stent restenosis, by intravascular ultrasound (IVUS) analysis, between 50 patients who received radiation therapy and 9 controls. The changes (delta: follow-up-post-intervention) of the external elastic membrane (EEM), the lumen and other IVUS variables, were compared between the segments having received radiation therapy and those in the controls.
RESULTS
Significant differences were found between the 2 groups, and were as follows: the delta EEM and delta lumen areas were 0.3mm2 and -1.0mm2, (p=0.005) and 0.2mm2 and -1.3mm2, (p<0.001) in those radiated and the controls, respectively.
CONCLUSION
In conclusion, compared with the changes on the vessel shrinkage of the control group, there was significant vessel enlargement in the non-stented adjacent segments having received radiation therapy.

Keyword

Intravascular ultrasonography; Stents; Coronary arteriosclerosis; Brachytherapy

MeSH Terms

Brachytherapy
Coronary Artery Disease
Humans
Membranes
Stents
Ultrasonography*
Ultrasonography, Interventional
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