Comparison of angiographic and clinical outcomes between rotational atherectomy and cutting balloon angioplasty followed by radiation therapy with a rhenium 188-mercaptoacetyltriglycine-filled balloon in the treatment of diffuse in-stent restenosis

Seung Whan Lee, Seong Wook Park, Myeong Ki Hong, Young Hak Kim, Ki Hoon Han, Dae Hyuk Moon, Seung Jun Oh, Cheol Whan Lee, Jae Joong Kim, Seung Jung Park

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: Rotational atherectomy (RA) and cutting balloon angioplasty (CBA) have been shown to effectively dilate in-stent restenosis (ISR). It is not known, however, which of these technique, when followed by β-radiation, is more effective. Therefore, we performed a prospective randomized study comparing RA and CBA before β-radiation therapy for diffuse ISR. Methods: Patients with diffuse ISR were randomly assigned to receive RA (group 1, n = 58) or CBA (group 2, n = 55) before β-radiation therapy with a rhenium 188-mercaptoacetyltriglycine-filled balloon, with the radiation dose being 18 Gy at a depth of 1.0 mm into the vessel wall. The primary end point was angiographic restenosis at 6 months, and the secondary end point was major adverse cardiac events (myocardial infarction, death, target lesion revascularization) at 9 months. Results: The 2 groups were similar in baseline characteristics. Mean lesion length was 21.0 ± 11.2 mm in group 1 and 20.8 ± 10.2 mm in group 2 (P = .77). Radiation was delivered successfully to all patients. We obtained 6-month angiographic follow-up in 90 patients (80%). The rates of angiographic restenosis were 14.9% (7 of 47) in group 1 and 14.0% (6 of 43) in group 2 (P = .89). No patient experienced myocardial infarction or death during the 9-month follow-up period. Rates of target lesion revascularization or major adverse cardiac events were 3.4% in group 1 and 3.6% in group 2 (P = .94) during the 9-month follow-up. Conclusions: Either RA or CBA, followed by β-radiation using a rhenium 188-mercaptoacetyltriglycine- filled balloon, is equally safe and effective for diffuse ISR in 6-month angiographic and 9-month clinical outcomes.

Original languageEnglish
Pages (from-to)577-582
Number of pages6
JournalAmerican heart journal
Volume150
Issue number3
DOIs
Publication statusPublished - 2005 Sep

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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