Vol 62, No 6 (2005)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
Get Citation

Effectiveness and determinants of the long-term β intracoronary brachytherapy results

Adam Witkowski, Łukasz Kalińczuk, Zbigniew Chmielak, Jarosław Łyczek, Jerzy Pręgowski, Maria Kawczyńska, Wojciech Bulski, Anna Kulik, Cezary Kępka, Mariusz Kruk, Stanisław Pszona, Witold Rużyłło
Kardiol Pol 2005;62(6):552-557.
Vol 62, No 6 (2005)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: Effectiveness evaluation and search for the factors determining long-term results of β intracoronary brachytherapy (ICBT) are of a special importance in an upcoming era of drug- eluting stents usage for a wide range of clinical indications: de novo and in-stent restenosis lesions.
Methods.: One hundred forty eight consecutive patients (59.6±9.6 years, 72% men) treated with β ICBT for in-stent restenosis (ISR) or de novo lesions were studied. There were 135 ISR in 121 patients and 31 de novo lesions in 27 patients. Follow-up coronary angiography was performed in all patients after a mean of 8.9±4.5 months. Detailed qualitative and quantitative angiographic analysis of pre-, peri- and postprocedural as well as follow-up angiograms was performed.
Results: Forty five percent of patients treated for de novo lesions were diabetic. Thirty five percent of all targets were located in vessels with a reference vessel diameter <2.5 mm. Furthermore, 77% of ISR lesions were in Class >1 according to the Mehran classification. The mean length of an irradiated segment was 37.6 mm. The overall recurrent restenosis rate was 28.3%. Multivariate analysis revealed that the reference vessel diameter and the presence of edge injury within the proximal 32P source dose-fall off were the only independent predictors of recurrent restenosis after ICBT (OR 0.46; 95%CI 0.24-0.89; p=0.021 and OR 2.55; 95%CI 1.23-5.25; p=0.011, respectively).
Conclusions: Recurrent restenosis after &#946; intracoronary brachytherapy treatment is negatively associated with the target vessel size. Presence of edge injury within the proximal 32P source dose-fall increases the frequency of recurrent renarrowing after ICBT. Our results indicate that target vessel size should be taken into account in optimising interventional strategy for ISR treatment: drug eluting stents versus intracoronary brachytherpy. Avoidance of edge injury within the proximal 32P source *dose fall- off* is strongly recommended while ICBT application.

Abstract

Background: Effectiveness evaluation and search for the factors determining long-term results of &#946; intracoronary brachytherapy (ICBT) are of a special importance in an upcoming era of drug- eluting stents usage for a wide range of clinical indications: de novo and in-stent restenosis lesions.
Methods.: One hundred forty eight consecutive patients (59.6&plusmn;9.6 years, 72% men) treated with &#946; ICBT for in-stent restenosis (ISR) or de novo lesions were studied. There were 135 ISR in 121 patients and 31 de novo lesions in 27 patients. Follow-up coronary angiography was performed in all patients after a mean of 8.9&plusmn;4.5 months. Detailed qualitative and quantitative angiographic analysis of pre-, peri- and postprocedural as well as follow-up angiograms was performed.
Results: Forty five percent of patients treated for de novo lesions were diabetic. Thirty five percent of all targets were located in vessels with a reference vessel diameter <2.5 mm. Furthermore, 77% of ISR lesions were in Class >1 according to the Mehran classification. The mean length of an irradiated segment was 37.6 mm. The overall recurrent restenosis rate was 28.3%. Multivariate analysis revealed that the reference vessel diameter and the presence of edge injury within the proximal 32P source dose-fall off were the only independent predictors of recurrent restenosis after ICBT (OR 0.46; 95%CI 0.24-0.89; p=0.021 and OR 2.55; 95%CI 1.23-5.25; p=0.011, respectively).
Conclusions: Recurrent restenosis after &#946; intracoronary brachytherapy treatment is negatively associated with the target vessel size. Presence of edge injury within the proximal 32P source dose-fall increases the frequency of recurrent renarrowing after ICBT. Our results indicate that target vessel size should be taken into account in optimising interventional strategy for ISR treatment: drug eluting stents versus intracoronary brachytherpy. Avoidance of edge injury within the proximal 32P source *dose fall- off* is strongly recommended while ICBT application.
Get Citation

Keywords

intracoronary brachytherapy - in-stent restenosis

About this article
Title

Effectiveness and determinants of the long-term β intracoronary brachytherapy results

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 62, No 6 (2005)

Pages

552-557

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2005;62(6):552-557.

Keywords

intracoronary brachytherapy - in-stent restenosis

Authors

Adam Witkowski
Łukasz Kalińczuk
Zbigniew Chmielak
Jarosław Łyczek
Jerzy Pręgowski
Maria Kawczyńska
Wojciech Bulski
Anna Kulik
Cezary Kępka
Mariusz Kruk
Stanisław Pszona
Witold Rużyłło

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl