Comparison of angiographic and clinical outcomes between rotational atherectomy versus 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, Jae Hwan Lee, Young Hak Kim, Hyuk Moon Dae, Jun Oh Seung, Whan Lee Cheol, Jae Joong Kim, Seung Jung Park

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Background: The purpose of this study was to compare the efficacy of rotational atherectomy (RA) with simple balloon angioplasty, prior to beta-radiation therapy with a rhenium-188-mercaptoacetyltriglycine ( 188 Re-MAG 3 )-filled balloon for diffuse in-stent restenosis (ISR). Methods: After completing 50 cases with RA prior to beta-radiation (Group I), we performed optimal balloon angioplasty followed by beta-radiation in the next 53 consecutive patients (Group II) for the treatment of diffuse ISR. The radiation dose was 15 Gy at a depth of 1.0 mm into the vessel wall. Results: The baseline clinical and angiographic characteristics were similar between the two groups. The mean length of the lesion was 25.6±12.7 mm in Group I and 22.9±8.6 mm in Group II (p=0.26). Radiation was successfully delivered to all patients, with a mean irradiation time of 179±55 s. The 6-month angiographic restenosis rate was 10% (5/50) in Group I versus 33% (17/51) in Group II (p=0.007). No adverse event including myocardial infarction, death, or stent thrombosis occurred during the 1-year follow-up period. The risk of a target lesion revascularization or a major adverse cardiac event was significantly lower in Group I than in Group II (two patients in Group I vs. nine patients in Group II; OR, 0.20; 95% CI, 0.04-0.96; p=0.04). Conclusion: Concomitant treatment with rotational atherectomy and beta-irradiation using a 188 Re-MAG 3 -filled balloon for diffuse ISR has a synergistic effect, in terms of 6-month angiographic restenosis and 1-year cardiac event-free survival.

Original languageEnglish
Pages (from-to)179-185
Number of pages7
JournalInternational Journal of Cardiology
Issue number2
Publication statusPublished - 2005 Jul 10


All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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