Intracoronary β-brachytherapy using a rhenium-188 filled balloon catheter in restenotic lesions of native coronary arteries and venous bypass grafts

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Jochen Wöhrle - , Universität Ulm (Autor:in)
  • Bernd Joachim Krause - , Universität Ulm (Autor:in)
  • Thorsten Nusser - , Universität Ulm (Autor:in)
  • Felix M. Mottaghy - , Universität Ulm (Autor:in)
  • Thomas Habig - , Universität Ulm (Autor:in)
  • Matthias Kochs - , Universität Ulm (Autor:in)
  • Jörg Kotzerke - , Klinik und Poliklinik für Nuklearmedizin (Autor:in)
  • Sven N. Reske - , Universität Ulm (Autor:in)
  • Vinzenz Hombach - , Universität Ulm (Autor:in)
  • Martin Höher - , Klinikum Bayreuth GmbH (Autor:in)

Abstract

Purpose: We have previously demonstrated the efficacy of intracoronary β-brachytherapy using a liquid 188Re-filled balloon in a randomised trial including de novo lesions. Percutaneous coronary interventions in restenotic lesions and in stenoses of venous bypass grafts are characterised by a high recurrence rate for restenosis and re-interventions. Against this background, we wanted to assess the impact of intracoronary β-brachytherapy using a liquid 188Re-filled balloon in restenotic lesions in native coronary arteries and venous bypass grafts. Methods: In 243 patients, β-brachytherapy with 22.5 Gy was applied at a tissue depth of 0.5 mm. Patients were followed up angiographically after 6 months and clinically for 12 months. The primary clinical endpoint was the incidence of MACE (death, myocardial infarction, target vessel revascularisation). Secondary angiographic endpoints were late loss and binary restenosis rate in the total segment. Results: All irradiation procedures were successfully performed. A total of 222 lesions were in native coronary arteries; 21 were bypass lesions. Mean irradiation length was 41.6±17.3 mm (range 20-150 mm) in native coronary arteries and 48.1±33.9 mm (range 30-180 mm) in bypass lesions; the reference diameter was 2.57±0.52 mm and 2.83±0.76 mm, respectively. There was no vessel thrombosis during antiplatelet therapy. Angiographic/clinical follow-up rate was 84%/100%. MACE rate was 17.6% in the native coronary artery group and 38.1% in the CABG group (p<0.03). Binary restenosis rate was 22.5% and 55.6% (p<0.01), and late loss was 0.38±0.72 mm and 1.33±1.11 mm (p<0.001), respectively. Conclusions: We conclude that intracoronary β-brachytherapy with a liquid 188Re-filled balloon using 22.5 Gy at a tissue depth of 0.5 mm in restenotic lesions is safe. It is associated with a low binary restenosis rate, resulting in a low occurrence rate of MACE within 12 months in restenotic lesions in native coronary arteries but not in vein grafts.

Details

OriginalspracheEnglisch
Seiten (von - bis)1314-1320
Seitenumfang7
FachzeitschriftEuropean Journal of Nuclear Medicine and Molecular Imaging
Jahrgang33
Ausgabenummer11
PublikationsstatusVeröffentlicht - Nov. 2006
Peer-Review-StatusJa

Externe IDs

Scopus 33750314005
PubMed 16791596

Schlagworte

Schlagwörter

  • Brachytherapy, Coronary heart disease, Restenotic lesion, Rhenium-188