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Feasibility and efficacy of tandem positioning on angiographic and clinical outcomes in the Intimal Hyperplasia Inhibition With Beta In-Stent Trial

      Diffuse in-stent restenosis is associated with high recurrence rates after repeat percutaneous coronary intervention.
      • Mehran R.
      • Dangas G.
      • Abizaid A.S.
      • Mintz G.S.
      • Lansky A.J.
      • Satler L.F.
      • Pichard A.D.
      • Kent K.M.
      • Stone G.W.
      • Leon M.B.
      Angiographic patterns of in-stent restenosis classification and implications for long-term outcome.
      ,
      • Reimers B.
      • Moussa I.
      • Akiyama T.
      • Tucci G.
      • Ferraro M.
      • Martini G.
      • Blengino S.
      • Di Mario C.
      • Colombo A.
      Long-term clinical follow-up after successful repeat percutaneous intervention for stent restenosis.
      Recently, several clinical trials demonstrated that vascular brachytherapy is effective in reducing restenosis.
      • Waksman R.
      • White R.L.
      • Chan R.C.
      • Bass B.G.
      • Geirlach L.
      • Mintz G.S.
      • Satler L.F.
      • Mehran R.
      • Serruys P.W.
      • Lansky A.J.
      • et al.
      Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis.
      ,
      • Raizner A.E.
      • Oesterle S.N.
      • Waksman R.
      • Serruys P.W.
      • Colombo A.
      • Lim Y.L.
      • Yeung A.C.
      • van der Giessen W.J.
      • Vandertie L.
      • et al.
      Inhibition of restenosis with beta-emitting radiotherapy report of the Proliferation Reduction with Vascular Energy Trial (PREVENT).
      ,
      • Waksman R.
      • Raizner A.E.
      • Yeung A.C.
      • Lansky A.J.
      • Vandertie L.
      Use of localised Intracoronary Beta radiation in Treatment of In-stent restenosis the INHIBIT randomised controlled trial.
      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.
      • Sabate M.
      • Costa M.A.
      • Kozuma K.
      • Kay I.P.
      • van der Giessen W.J.
      • Coen V.L.
      • Ligthart J.M.
      • Serrano P.
      • Levendag P.C.
      • Serruys P.W.
      Geographic miss a cause of treatment failure in radio-oncology applied to intracoronary radiation therapy.
      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.
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      References

        • Mehran R.
        • Dangas G.
        • Abizaid A.S.
        • Mintz G.S.
        • Lansky A.J.
        • Satler L.F.
        • Pichard A.D.
        • Kent K.M.
        • Stone G.W.
        • Leon M.B.
        Angiographic patterns of in-stent restenosis.
        Circulation. 1999; 100: 1872-1878
        • Reimers B.
        • Moussa I.
        • Akiyama T.
        • Tucci G.
        • Ferraro M.
        • Martini G.
        • Blengino S.
        • Di Mario C.
        • Colombo A.
        Long-term clinical follow-up after successful repeat percutaneous intervention for stent restenosis.
        J Am Coll Cardiol. 1997; 30: 186-192
        • Waksman R.
        • White R.L.
        • Chan R.C.
        • Bass B.G.
        • Geirlach L.
        • Mintz G.S.
        • Satler L.F.
        • Mehran R.
        • Serruys P.W.
        • Lansky A.J.
        • et al.
        Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis.
        Circulation. 2000; 101: 2165-2171
        • Raizner A.E.
        • Oesterle S.N.
        • Waksman R.
        • Serruys P.W.
        • Colombo A.
        • Lim Y.L.
        • Yeung A.C.
        • van der Giessen W.J.
        • Vandertie L.
        • et al.
        Inhibition of restenosis with beta-emitting radiotherapy.
        Circulation. 2000; 102: 951-958
        • Waksman R.
        • Raizner A.E.
        • Yeung A.C.
        • Lansky A.J.
        • Vandertie L.
        Use of localised Intracoronary Beta radiation in Treatment of In-stent restenosis.
        Lancet. 2002; 359: 551-557
        • Sabate M.
        • Costa M.A.
        • Kozuma K.
        • Kay I.P.
        • van der Giessen W.J.
        • Coen V.L.
        • Ligthart J.M.
        • Serrano P.
        • Levendag P.C.
        • Serruys P.W.
        Geographic miss.
        Circulation. 2000; 101: 2467-2471
        • Gillette E.L.
        • Powers B.E.
        • McChesney S.L.
        • Park R.D.
        • Withrow S.J.
        Response of aorta and branch arteries to experimental intraoperative irradiation.
        Int J Radiat Oncol Biol Phys. 1989; 17: 1247-1255
        • Condado J.A.
        • Waksman R.
        • Gurdiel O.
        • Espinosa R.
        • Gonzalez J.
        • Burger B.
        • Villoria G.
        • Acquatella H.
        • Crocker I.R.
        • Seung K.B.
        • Liprie S.F.
        Long-term angiographic and clinical outcome after percutaneous transluminal coronary angioplasty and intracoronary radiation therapy in humans.
        Circulation. 1997; 96: 727-732