Incidence and predictors of late recurrence after β-radiation therapy with a 188Re-MAG3-filled balloon for diffuse in-stent restenosis

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

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Abstract

Background: The long-term fate of patent irradiated segments at 6 months after β-radiation therapy has not been sufficiently evaluated. Methods: Two-year follow-up angiography was performed in 52 patients with patent irradiated segments at 6 months after β-radiation with a rhenium 188-mercaptoacetyltriglycine-filled balloon for diffuse in-stent restenosis. We evaluated late recurrence (LR) and its predictors after β-radiation. Results: Late recurrence at 2 years after radiation was observed in 10 (19.2%) of 52 patients. The minimal lumen diameter (MLD) progressively decreased, from 2.67 ± 0.44 mm at postprocedure to 2.42 ± 0.53 mm at 6 months to 2.09 ± 0.75 mm at 2 years (P = .001). In the 42 patients without LR, the MLD decreased from postprocedure (2.74 ± 0.43 mm) to 6 months (2.44 ± 0.54 mm; P = .006), but did not change between 6 months and 2 years (2.35 ± 0.49 mm, P = .13). In the LR group, the MLD was unchanged from postprocedure (2.33 ± 0.29 mm) to 6 months (2.30 ± 0.43 mm; P = .81), but decreased significantly between 6 months and 2 years (1.02 ± 0.75 mm, P = .001). Multivariate analysis identified postprocedural MLD as an independent predictor of LR (odds ratio 0.025, 95% CI 0.007-0.94, P = .04). Late target lesion revascularization was performed in 6 patients (11.5%) between 6 months and 2 years after radiation. Conclusion: Although LR after radiation was observed in some patients, irradiated segments remained stable for up to 2 years in most patients. Smaller postprocedural MLD, followed by delayed late loss between 6 months and 2 years, was associated with LR.

Original languageEnglish
Pages (from-to)158-163
Number of pages6
JournalAmerican heart journal
Volume151
Issue number1
DOIs
Publication statusPublished - 2006 Jan 1

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Lee, S. W., Park, S. W., Hong, M. K., Kim, Y. H., Han, K. H., Kim, J., Park, J. H., Oh, S. J., Moon, D. H., Oh, S. J., Lee, C. W., Kim, J. J., & Park, S. J. (2006). Incidence and predictors of late recurrence after β-radiation therapy with a 188Re-MAG3-filled balloon for diffuse in-stent restenosis. American heart journal, 151(1), 158-163. https://doi.org/10.1016/j.ahj.2005.02.011