Diffuse in-stent restenosis is associated with high recurrence rates after repeat
percutaneous coronary intervention.
1
,
2
Recently, several clinical trials demonstrated that vascular brachytherapy is effective
in reducing restenosis.
3
,
4
,
5
One emerging issue in vascular brachytherapy of in-stent restenosis lesions is that
of geographic miss: segments of artery are injured, but not adequately radiated.
6
Because this is especially important in longer lesions, tandem positioning was mandated
by protocol in the Intimal Hyperplasia Inhibition with Beta In-stent Trial (INHIBIT)
in all patients with long, injured segments. We conducted an independent prospective
analysis of all patients treated with tandem-source positioning to evaluate the precision
of manual stepping and the safety and efficacy of this strategy.To read this article in full you will need to make a payment
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References
- Angiographic patterns of in-stent restenosis.Circulation. 1999; 100: 1872-1878
- Long-term clinical follow-up after successful repeat percutaneous intervention for stent restenosis.J Am Coll Cardiol. 1997; 30: 186-192
- Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis.Circulation. 2000; 101: 2165-2171
- Inhibition of restenosis with beta-emitting radiotherapy.Circulation. 2000; 102: 951-958
- Use of localised Intracoronary Beta radiation in Treatment of In-stent restenosis.Lancet. 2002; 359: 551-557
- Geographic miss.Circulation. 2000; 101: 2467-2471
- Response of aorta and branch arteries to experimental intraoperative irradiation.Int J Radiat Oncol Biol Phys. 1989; 17: 1247-1255
- Long-term angiographic and clinical outcome after percutaneous transluminal coronary angioplasty and intracoronary radiation therapy in humans.Circulation. 1997; 96: 727-732
Article Info
Publication History
Accepted:
January 24,
2003
Received in revised form:
January 24,
2003
Received:
October 24,
2002
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.