Intracoronary 166Holmium brachytherapy combined with cutting balloon angioplasty for the treatment of in-stent restenosis

Sungha Park, Woong Chol Kang, Ji Hyuk Rhee, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Jong Doo Lee, Won Heum Shim, Seung Yun Cho

Research output: Contribution to journalArticle

Abstract

Background: Brachytherapy is the only effective treatment for in-stent restenosis (ISR). The preliminary data regarding cutting balloon angioplasty (CBA) are encouraging and suggest a possible additive effect of CBA with combination with vascular brachytherapy. Hence, in this study, we evaluated the efficacy, feasibility and safety of cutting balloon angioplasty followed by intracoronary Holmium (166Ho) brachytherapy for the treatment of in-stent restenosis. Methods and Materials: Fifty-six patients with in-stent restenosis were treated with cutting balloon angioplasty and intracoronary 166Ho brachytherapy. For irradiation, a balloon approximately 10 mm longer than the initially deployed stent was filled with liquid 166Ho and placed at the in-stent restenosis lesion. The patients were followed angiographically at 6 months and clinically for 19.0±9.8 months. Results: The initial procedures were successful in all of the patients. The preprocedural average minimal luminal diameter (MLD) and stenosis rate were 0.57±0.30 mm and 80.2±11.6%, respectively. The MLD and residual stenosis immediately after the procedure was 2.43±0.37 and 13.8±9.9%, respectively. Thirty-nine (69.6%) patients have completed their angiographic follow-up at 6 months. The MLD, late loss and loss index at follow-up were 1.97±0.79 mm, 0.72±0.69 mm and 0.36±0.34, respectively. The target lesion restenosis rate was 20.5% and the target lesion revascularization rate was 3.6%. None of these patients presented with adverse coronary events such as MI, sudden cardiac death or stent thrombosis during the follow up period. Conclusion The combination therapy using cutting balloon angioplasty and intracoronary 166Ho brachytherapy may be an effective new treatment modality for in-stent restenosis.

Original languageEnglish
Pages (from-to)119-125
Number of pages7
JournalCardiovascular Radiation Medicine
Volume4
Issue number3
DOIs
Publication statusPublished - 2003 Jan 1

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Balloon Angioplasty
Brachytherapy
Stents
Therapeutics
Pathologic Constriction
Holmium
Sudden Cardiac Death
Blood Vessels
Thrombosis
Safety

All Science Journal Classification (ASJC) codes

  • Surgery
  • Molecular Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Park, Sungha ; Kang, Woong Chol ; Rhee, Ji Hyuk ; Ko, Young Guk ; Choi, Donghoon ; Jang, Yangsoo ; Lee, Jong Doo ; Shim, Won Heum ; Cho, Seung Yun. / Intracoronary 166Holmium brachytherapy combined with cutting balloon angioplasty for the treatment of in-stent restenosis. In: Cardiovascular Radiation Medicine. 2003 ; Vol. 4, No. 3. pp. 119-125.
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title = "Intracoronary 166Holmium brachytherapy combined with cutting balloon angioplasty for the treatment of in-stent restenosis",
abstract = "Background: Brachytherapy is the only effective treatment for in-stent restenosis (ISR). The preliminary data regarding cutting balloon angioplasty (CBA) are encouraging and suggest a possible additive effect of CBA with combination with vascular brachytherapy. Hence, in this study, we evaluated the efficacy, feasibility and safety of cutting balloon angioplasty followed by intracoronary Holmium (166Ho) brachytherapy for the treatment of in-stent restenosis. Methods and Materials: Fifty-six patients with in-stent restenosis were treated with cutting balloon angioplasty and intracoronary 166Ho brachytherapy. For irradiation, a balloon approximately 10 mm longer than the initially deployed stent was filled with liquid 166Ho and placed at the in-stent restenosis lesion. The patients were followed angiographically at 6 months and clinically for 19.0±9.8 months. Results: The initial procedures were successful in all of the patients. The preprocedural average minimal luminal diameter (MLD) and stenosis rate were 0.57±0.30 mm and 80.2±11.6{\%}, respectively. The MLD and residual stenosis immediately after the procedure was 2.43±0.37 and 13.8±9.9{\%}, respectively. Thirty-nine (69.6{\%}) patients have completed their angiographic follow-up at 6 months. The MLD, late loss and loss index at follow-up were 1.97±0.79 mm, 0.72±0.69 mm and 0.36±0.34, respectively. The target lesion restenosis rate was 20.5{\%} and the target lesion revascularization rate was 3.6{\%}. None of these patients presented with adverse coronary events such as MI, sudden cardiac death or stent thrombosis during the follow up period. Conclusion The combination therapy using cutting balloon angioplasty and intracoronary 166Ho brachytherapy may be an effective new treatment modality for in-stent restenosis.",
author = "Sungha Park and Kang, {Woong Chol} and Rhee, {Ji Hyuk} and Ko, {Young Guk} and Donghoon Choi and Yangsoo Jang and Lee, {Jong Doo} and Shim, {Won Heum} and Cho, {Seung Yun}",
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Intracoronary 166Holmium brachytherapy combined with cutting balloon angioplasty for the treatment of in-stent restenosis. / Park, Sungha; Kang, Woong Chol; Rhee, Ji Hyuk; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo; Lee, Jong Doo; Shim, Won Heum; Cho, Seung Yun.

In: Cardiovascular Radiation Medicine, Vol. 4, No. 3, 01.01.2003, p. 119-125.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intracoronary 166Holmium brachytherapy combined with cutting balloon angioplasty for the treatment of in-stent restenosis

AU - Park, Sungha

AU - Kang, Woong Chol

AU - Rhee, Ji Hyuk

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Lee, Jong Doo

AU - Shim, Won Heum

AU - Cho, Seung Yun

PY - 2003/1/1

Y1 - 2003/1/1

N2 - Background: Brachytherapy is the only effective treatment for in-stent restenosis (ISR). The preliminary data regarding cutting balloon angioplasty (CBA) are encouraging and suggest a possible additive effect of CBA with combination with vascular brachytherapy. Hence, in this study, we evaluated the efficacy, feasibility and safety of cutting balloon angioplasty followed by intracoronary Holmium (166Ho) brachytherapy for the treatment of in-stent restenosis. Methods and Materials: Fifty-six patients with in-stent restenosis were treated with cutting balloon angioplasty and intracoronary 166Ho brachytherapy. For irradiation, a balloon approximately 10 mm longer than the initially deployed stent was filled with liquid 166Ho and placed at the in-stent restenosis lesion. The patients were followed angiographically at 6 months and clinically for 19.0±9.8 months. Results: The initial procedures were successful in all of the patients. The preprocedural average minimal luminal diameter (MLD) and stenosis rate were 0.57±0.30 mm and 80.2±11.6%, respectively. The MLD and residual stenosis immediately after the procedure was 2.43±0.37 and 13.8±9.9%, respectively. Thirty-nine (69.6%) patients have completed their angiographic follow-up at 6 months. The MLD, late loss and loss index at follow-up were 1.97±0.79 mm, 0.72±0.69 mm and 0.36±0.34, respectively. The target lesion restenosis rate was 20.5% and the target lesion revascularization rate was 3.6%. None of these patients presented with adverse coronary events such as MI, sudden cardiac death or stent thrombosis during the follow up period. Conclusion The combination therapy using cutting balloon angioplasty and intracoronary 166Ho brachytherapy may be an effective new treatment modality for in-stent restenosis.

AB - Background: Brachytherapy is the only effective treatment for in-stent restenosis (ISR). The preliminary data regarding cutting balloon angioplasty (CBA) are encouraging and suggest a possible additive effect of CBA with combination with vascular brachytherapy. Hence, in this study, we evaluated the efficacy, feasibility and safety of cutting balloon angioplasty followed by intracoronary Holmium (166Ho) brachytherapy for the treatment of in-stent restenosis. Methods and Materials: Fifty-six patients with in-stent restenosis were treated with cutting balloon angioplasty and intracoronary 166Ho brachytherapy. For irradiation, a balloon approximately 10 mm longer than the initially deployed stent was filled with liquid 166Ho and placed at the in-stent restenosis lesion. The patients were followed angiographically at 6 months and clinically for 19.0±9.8 months. Results: The initial procedures were successful in all of the patients. The preprocedural average minimal luminal diameter (MLD) and stenosis rate were 0.57±0.30 mm and 80.2±11.6%, respectively. The MLD and residual stenosis immediately after the procedure was 2.43±0.37 and 13.8±9.9%, respectively. Thirty-nine (69.6%) patients have completed their angiographic follow-up at 6 months. The MLD, late loss and loss index at follow-up were 1.97±0.79 mm, 0.72±0.69 mm and 0.36±0.34, respectively. The target lesion restenosis rate was 20.5% and the target lesion revascularization rate was 3.6%. None of these patients presented with adverse coronary events such as MI, sudden cardiac death or stent thrombosis during the follow up period. Conclusion The combination therapy using cutting balloon angioplasty and intracoronary 166Ho brachytherapy may be an effective new treatment modality for in-stent restenosis.

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