Comparison of a centered P-32 source wire system with a noncentered Sr-90/Y brachytherapy system for intracoronary beta-radiation following PCI of diffuse in-stent restenosis

被引：2

作者：

Haase, Juergen ^{[1
]}

von Neumann-Cosel, Peter ^{[2
]}

Damm, Michael ^{[1
]}

Hofmann, Manfred ^{[1
]}

Stoerger, Hans ^{[1
]}

Isner, Daniel ^{[1
]}

Bergmann, Michael ^{[1
]}

Piancatelli, Claudia ^{[1
]}

Schaechinger, Volker ^{[3
]}

Schwarz, Franz ^{[1
]}

机构：

[1] Red Cross Hosp, Cardiol Ctr, Frankfurt, Germany

[2] Univ Technol Darmstadt, Inst Nucl Phys, Darmstadt, Germany

[3] Univ Hosp, Dept Cardiol, Frankfurt, Germany

来源：

CARDIOVASCULAR REVASCULARIZATION MEDICINE | 2005年 / 6卷 / 04期

关键词：

P-32 source wire system; Sr-90/Y brachytherapy system; beta-Radiation;

D O I：

10.1016/j.carrev.2005.09.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: We investigated the potential impact of differences in effective radiation dose between the centered Guidant P-32 source wire system and the noncentered Novoste Sr-90/Y BetaCath system on clinical and angiographic outcomes of intracoronary brachytherapy for the prevention of in-stent restenosis. Methods: From 10/00 to 05/04, a total of 400 patients underwent percutaneous coronary intervention (PCI) with brachytherapy for diffuse in-stent restenosis at our institution. Following balloon dilatation, patient Group A (n= 200) was treated with the centered P-32 Galileo source wire system, patient Group B (n= 200) was treated with the noncentered 90 Sr/Y BetaCath radiation system. In Group A, the prescribed dose of 20 Gy was applied in 1-mm depth of the vessel wall. In Group B, the prescribed dose of 18.4 Gy was applied for visual reference vessel sizes >2.7 and <3.35 mm, 23 Gy for >3.36 and b4.00 mm, and 25.3 Gy for >4.00 mm, each calculated at a distance of 2 mm from the center line of the radiation source. Patients received aspirin and clopidogrel over 12 months. Primary endpoint was target lesion revascularization (TLR) at 6 months. Secondary endpoints were the binary restenosis rate and major adverse cardiac event (MACE) at 30 days and 6 months. Results: At 30 days, one patient of each group underwent PCI at a nontarget lesion (0.5%). At 6 months, MACEs were equally distributed in both groups. Target lesion revascularization at 6 months was 5.9% in Group A and 9.2% in Group B (P=.08). Binary angiographic restenosis rate at 6 months was 5.5% in Group A and 11.2% in Group B (P=. 014). Conclusion: Intracoronary beta-radiation using the centered P-32 source wire system yielded a significant reduction of recurrence rate compared to the noncentered S-90/Y BetaCath system after PCI of diffuse in-stent restenosis. There was a nonsignificant trend toward reduction of TLR among patients treated with the centered P-32 source wire system. (C) 2005 Elsevier Inc. All rights reserved.

引用

页码：140 / 146

页数：7

共 27 条

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