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

Authors
 Sungha Park  ;  Woong Chol Kang  ;  Seung Yun Cho  ;  Won-Heum Shim  ;  Jong-Doo Lee  ;  Yangsoo Jang  ;  Donghoon Choi  ;  Young-Guk Ko  ;  Ji-hyuk Rhee 
Citation
 Cardiovascular Radiation Medicine, Vol.4(3) : 119-125, 2003 
Journal Title
 Cardiovascular Radiation Medicine 
Issue Date
2003
MeSH
Aged ; Angioplasty, Balloon, Coronary* ; Blood Vessel Prosthesis Implantation ; Brachytherapy* ; Combined Modality Therapy ; Coronary Angiography ; Coronary Restenosis/diagnostic imaging ; Coronary Restenosis/epidemiology ; Coronary Restenosis/therapy* ; Female ; Follow-Up Studies ; Holmium/therapeutic use* ; Humans ; Male ; Middle Aged ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Prevalence ; Radiopharmaceuticals/therapeutic use* ; Risk Factors ; Stents* ; Treatment Outcome
Keywords
In-stent restenosis ; Cutting balloon angioplasty ; Intracoronary 166Ho brachytherapy
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
Full Text
http://www.sciencedirect.com/science/article/pii/S1522186503001811
DOI
10.1016/S1522-1865(03)00181-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Woong Chol(강웅철)
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Shim, Won Heum(심원흠)
Lee, Jong Doo(이종두)
Rhee, Ji Hyuk(이지혁)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Cho, Seung Yun(조승연)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/114683
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