Intracoronary brachytheraphy for in-stent restenosis using long sources reduces restenosis

Ramanjit Bagga, Annapoorna Kini, Paul Lee, Ajay Agarwal, Mary Duffy, Michael Kim, Samin Sharma

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Edge restenosis ("candy wrapper" effect) and late thrombosis remain a problem in various randomized intracoronary brachytherapy (ICBT) trails for the treatment of in-stent restenosis (ISR). Target vessel revascularization (TVR) due to target lesion revascularization (TLR) and edge restenosis can be decreased with the of use of longer ICBT sources and debulking devices and has not been systematically studied. We analyzed 226 patients with ISR (240 vessels/264 lesions; average lesion 17.5 ± 8.9 mm) who had lesion debulking followed by 90 Strontium (Sr) b-irradiation using the Novoste Betacath® system (30 mm source in 144 vessels and 40 source in 96 vessels). Dual antiplatelet therapy was recommended for one year. At follow-up of 12 ± 2 months, clinical TVR occurred in 9.7%, with TLR in 7.1% and non-TLR in 2.6% of cases. There was no delayed or late subacute thrombosis. Beta-irradiation using a longer 90Sr source after lesion modification with cutting balloon (CB) and/or rotational atherectomy (RA), along with the use of long-term dual antiplatelet therapy is safe and associated with single-digit clinical restenosis.

Original languageEnglish
Pages (from-to)302-306
Number of pages5
JournalJournal of Invasive Cardiology
Issue number6
StatePublished - Jun 2005


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