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Limits: Publication Date from 2003/10/01 to
2005/02/01

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1:
Catheter Cardiovasc Interv. 2004 Oct;63(2):208-14.

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Late intravascular
ultrasound findings of patients treated with brachytherapy for diffuse
in-stent restenosis.

Hong MK, Mintz GS, Lee CW, Kim
YH, Lee SW, Moon DH, Oh SJ, Song JM, Han KH, Kang DH, Song JK, Kim JJ,
Park SW, Park SJ.

Department of Medicine, University of Ulsan
College of Medicine, Asan Medical Center, Seoul, South
Korea.

This study aimed at evaluating long-term (24-month)
effects of beta-irradiation (188Re-MAG3-filled balloon) using
intravascular ultrasound (IVUS) in patients with in-stent restenosis
(ISR). Long-term effects of beta-irradiation on intimal hyperplasia (IH)
within the stented segment and vessel and lumen dimensions of nonstented
adjacent segments in patients with ISR have not been sufficiently
evaluated. Two-year follow-up IVUS was performed in 30 patients with
patent ISR segments at 6-month follow-up angiography. Serial IVUS images
were acquired at five equidistant intrastent sites and at three
different reference segment sites. IH burden (%) was defined as 100 x
(IH/stent area). Mean intrastent IH area and IH burden significantly
increased between 6 and 24 months, from 2.1 +/- 1.1 to 2.6 +/- 1.4 mm2
(P < 0.001) and from 26% +/- 10% to 33% +/- 14% (P < 0.001),
respectively. There was a significant decrease of mean external elastic
membrane (from 10.1 +/- 3.9 to 9.7 +/- 3.9 mm2; P = 0.015) and lumen
area (from 5.6 +/- 2.3 to 5.1 +/- 2.3 mm2; P = 0.021) within distal
reference segments between 6 and 24 months. Target lesion
revascularization (TLR) was performed in six patients (20%) between 6
and 24 months after beta-irradiation therapy. There were no significant
differences between TLR and non-TLR groups except for a smaller minimum
lumen area at 24 months in the TLR group. Because of a small amount of
late loss between 6 and 24 months, most irradiated ISR vessel segments
remained stable for up to 2 years. However, quantitative evidence of
late catch-up was evident in most patients and was significantly
associated with 24-month TLR in some patients. (c) 2004 Wiley-Liss,
Inc.

PMID: 15390251 [PubMed - in process]

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