Intracoronary β-radiation therapy inhibits recurrence of in-stent restenosis

Ron Waksman, Balram Bhargava, Larry White, Rosanna C. Chan, Roxana Mehran, Alexandra J. Lansky, Gary S. Mintz, Lowell F. Satler, Augusto D. Pichard, Martin B. Leon, Kenneth K. Kent

Research output: Contribution to journalArticlepeer-review

313 Scopus citations

Abstract

Background - Intracoronary γ-radiation therapy reduces recurrent in- stent restenosis (ISR). This study, BETA WRIST (Washington Radiation for In- Stent restenosis Trial) was designed to examine the efficacy and safety of the β-emitter 90-yttrium for the prevention of recurrent ISR. Methods and Results - A total of 50 consecutive patients with ISR in native coronaries underwent percutaneous transluminal coronary angioplasty, laser angioplasty, rotational atherectomy, and/or stent implantation. Afterward, a segmented balloon catheter was positioned and automatically loaded with a 90-yttrium, 0.014-inch source wire that was 29 mm in length to deliver a dose of 20.6 Gy at 1.0 mm from the balloon surface. In 17 patients, manual stepping of the radiation catheter was necessary for lesions >25 mm in length. The radiation was delivered successfully to all patients, with a mean dwell time of 3.0±0.4 minutes. Fractionation of the dose due to ischemia was required in 11 patients. At 6 months, the binary angiographic restenosis rate was 22%, the target lesion revascularization rate was 26%, and the target vessel revascularization rate was 34%; all rates were significantly lower than those of the placebo group of γ-WRIST. Conclusions - β-Radiation with a 90- yttrium source used as adjunct therapy for patients with ISR results in a lower-than-expected rate of angiographic and clinical restenosis.

Original languageEnglish
Pages (from-to)1895-1898
Number of pages4
JournalCirculation
Volume101
Issue number16
DOIs
StatePublished - 25 Apr 2000
Externally publishedYes

Keywords

  • Beta rays
  • Brachytherapy
  • Restenosis
  • Stents

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