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, Myeongki 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 journalArticle

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 1

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Coronary Atherectomy
Balloon Angioplasty
Stents
Radiotherapy
Radiation
Myocardial Infarction
Therapeutics
Prospective Studies
rhenium-mercaptoacetyltriglycine

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, Seung Whan ; Park, Seong Wook ; Hong, Myeongki ; Kim, Young Hak ; Han, Ki Hoon ; Moon, Dae Hyuk ; Oh, Seung Jun ; Lee, Cheol Whan ; Kim, Jae Joong ; Park, Seung Jung. / 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. In: American Heart Journal. 2005 ; Vol. 150, No. 3. pp. 577-582.
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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.",
author = "Lee, {Seung Whan} and Park, {Seong Wook} and Myeongki Hong and Kim, {Young Hak} and Han, {Ki Hoon} and Moon, {Dae Hyuk} and Oh, {Seung Jun} and Lee, {Cheol Whan} and Kim, {Jae Joong} and Park, {Seung Jung}",
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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. / Lee, Seung Whan; Park, Seong Wook; Hong, Myeongki; Kim, Young Hak; Han, Ki Hoon; Moon, Dae Hyuk; Oh, Seung Jun; Lee, Cheol Whan; Kim, Jae Joong; Park, Seung Jung.

In: American Heart Journal, Vol. 150, No. 3, 01.09.2005, p. 577-582.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 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

AU - Lee, Seung Whan

AU - Park, Seong Wook

AU - Hong, Myeongki

AU - Kim, Young Hak

AU - Han, Ki Hoon

AU - Moon, Dae Hyuk

AU - Oh, Seung Jun

AU - Lee, Cheol Whan

AU - Kim, Jae Joong

AU - Park, Seung Jung

PY - 2005/9/1

Y1 - 2005/9/1

N2 - 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.

AB - 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.

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