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

Research output: Contribution to journalArticle

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Abstract

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
Volume102
Issue number2
DOIs
Publication statusPublished - 2005 Jul 10

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Coronary Atherectomy
Balloon Angioplasty
Beta Particles
Stents
Radiotherapy
Radiation
Therapeutics
Disease-Free Survival
Thrombosis
Myocardial Infarction
rhenium-mercaptoacetyltriglycine

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, Seung Whan ; Park, Seong Wook ; Hong, Myeongki ; Lee, Jae Hwan ; Kim, Young Hak ; Dae, Hyuk Moon ; Seung, Jun Oh ; Cheol, Whan Lee ; Kim, Jae Joong ; Park, Seung Jung. / 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. In: International Journal of Cardiology. 2005 ; Vol. 102, No. 2. pp. 179-185.
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title = "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",
abstract = "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.",
author = "Lee, {Seung Whan} and Park, {Seong Wook} and Myeongki Hong and Lee, {Jae Hwan} and Kim, {Young Hak} and Dae, {Hyuk Moon} and Seung, {Jun Oh} and Cheol, {Whan Lee} and Kim, {Jae Joong} and Park, {Seung Jung}",
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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. / Lee, Seung Whan; Park, Seong Wook; Hong, Myeongki; Lee, Jae Hwan; Kim, Young Hak; Dae, Hyuk Moon; Seung, Jun Oh; Cheol, Whan Lee; Kim, Jae Joong; Park, Seung Jung.

In: International Journal of Cardiology, Vol. 102, No. 2, 10.07.2005, p. 179-185.

Research output: Contribution to journalArticle

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T1 - 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

AU - Lee, Seung Whan

AU - Park, Seong Wook

AU - Hong, Myeongki

AU - Lee, Jae Hwan

AU - Kim, Young Hak

AU - Dae, Hyuk Moon

AU - Seung, Jun Oh

AU - Cheol, Whan Lee

AU - Kim, Jae Joong

AU - Park, Seung Jung

PY - 2005/7/10

Y1 - 2005/7/10

N2 - 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.

AB - 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.

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