Three-Year Clinical Follow-Up After Strontium-90/Yttrium-90 Beta-Irradiation for the Treatment of In-Stent Coronary Restenosis

• Published in: The American journal of cardiology Vol. 96; no. 10; pp. 1399 - 1403
• Main Authors: Baierl, Verena, Baumgartner, Simone, Pöllinger, Barbara, Leibig, Marcus, Rieber, Johannes, König, Andreas, Krötz, Florian, Sohn, Hae-Young, Siebert, Uwe, Haimerl, Wolfgang, Dühmke, Eckhart, Theisen, Karl, Klauss, Volker, Schiele, Thomas M.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15-11-2005; Elsevier; Elsevier Limited
• Subjects: Aged; Biological and medical sciences; Blood Vessel Prosthesis Implantation; Brachytherapy; Cardiology; Cardiology. Vascular system; Clinical outcomes; Clinical trials; Coronary Angiography; Coronary heart disease; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - therapy; Disease-Free Survival; Female; Follow-Up Studies; Heart; Humans; Male; Medical sciences; Middle Aged; Postoperative Complications - diagnostic imaging; Postoperative Complications - etiology; Prospective Studies; Radiopharmaceuticals - therapeutic use; Stents; Strontium Radioisotopes - therapeutic use; Treatment Outcome; Yttrium Radioisotopes - therapeutic use; Restenosis; Endoprosthesis; Beta irradiation; Follow up study; Coronary artery; Instrumentation therapy; Cardiovascular disease; Circulatory system; Cardiology; Coronary heart disease; Phlebology; Stent
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2005.06.087

Because late vessel failure has been speculated as a possible limitation of vascular brachytherapy, we conducted a prospective clinical evaluation at 6, 12, 24, and 36 months of follow-up after irradiation with strontium-90/yttrium-90 for in-stent restenosis, regardless of the patient’s symptomatic status. We report complete 3-year follow-up data for 106 consecutive patients. The cumulative rate of death at 6, 12, 24, and 36 months was 0.9%, 0.9%, 0.9%, and 1.9% respectively. The corresponding rates for acute ST-elevation myocardial infarction were 2.8%, 4.7%, 4.7%, and 4.7%, respectively. The cumulative rate of late thrombotic occlusion at 6, 12, 24, and 36 months was 3.8%, 4.7%, 4.7%, and 4.7%, respectively. The corresponding rates of target lesion revascularization and target vessel revascularization were 8.5% and 12.3% (p = 0.046), 14.2% (p = 0.157) and 18.0% (p = 0.046), 12.3% and 18.9% (p = 0.008), and 21.7% (p = 0.083) and 29.2% (p = 0.005), respectively. The cumulative rate of all major adverse cardiovascular events at 6, 12, 24, and 36 months was 16.1%, 24.5% (p = 0.003), 27.4% (p = 0.083), and 35.8% (p = 0.003), respectively. In conclusion, these results indicate a delayed and, even in the third year after the index procedure, continued restenotic process after β irradiation of in-stent restenotic lesions.