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European Heart Journal 2002 23(13):1038-1044; doi:10.1053/euhj.2001.3045
Copyright © 2002 by the European Society of Cardiology.
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Routine intracoronary beta-irradiation. Acute and one year outcome in patients at high risk for recurrence of stenosis

E. Regara, K. Kozumaa, G. Sianosa, V.L.M.A. Coenb, W.J. van der Giessena, D. Foleya, P. de Feytera, B. Rensinga, P. Smitsa, J. Vosa, A.H.M. Knooka, A.J. Wardeha, P.C. Levendagb and P.W. Serruysa,f1

a Department for Cardiology, Thoraxcenter, University Hospital Rotterdam, Rotterdam, The Netherlands
b Department for Radiotherapy, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

revised October 9, 2001; accepted October 10, 2001

Abstract

Aims Intracoronary radiation is a promising therapy potentially reducing restenosis following catheter-based interventions. Currently, only limited data on this treatment are available. The feasibility and outcome in daily routine practice, however, is unknown.

Methods and Results In 100 consecutive patients, intracoronary beta-radiation was performed with a 90Strontium system (Novoste Beta-CathTM) following angioplasty. Predominantly complex (73% type B2 and C) and long lesions (length 24·3±15·3mm) were included (37% de novo, 19% restenotic and 44% in-stent restenotic lesions). Radiation success was 100%. Mean prescribed dose was 19·8±2·5Gy. A pullback procedure was performed in 19% lesions. Geographic miss occurred in 8% lesions. Periprocedural thrombus formation occurred in four lesions, dissection in nine lesions. During hospital stay, no death, acute myocardial infarction, or repeat revascularization was observed. Major adverse cardiac events occurred predominantly between 6 and 12 months after the index procedure with major adverse cardiac event-free survival of 66% at 12 months (one death, 10 Q-wave myocardial infarctions, 23 target vessel revascularizations; ranked for worst event).

Conclusion Routine catheter-based intracoronary beta-radiation therapy after angioplasty is safe and feasible with a high acute procedural success. The clinical 1-year follow-up showed delayed occurrence of major adverse cardiac events between 6 and 12 months after the index procedure. Copyright 2001 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

Key Words: Brachytherapy, angioplasty, safety, radioisotopes

f1 Correspondence: Prof. P. W. Serruys, MD, PhD, Head of Interventional Department, Thoraxcentre, Bd. 408, University Hospital Dijkzigt, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.


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