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Gamma radiation for in‐stent restenosis: effect of lesion length on angiographic and clinical outcomes
Author(s) -
Mehran Roxana,
Iakovou Ioannis,
Dangas George,
Lansky Alexandra J.,
Stone Gregg W.,
Mintz Gary S.,
Kent Kenneth M.,
Pichard Augusto D.,
Satler Lowell F.,
Fahy Martin,
Leon Martin B.,
Waksman Ron
Publication year - 2004
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.10786
Subject(s) - medicine , restenosis , lesion , target lesion , stent , radiology , lumen (anatomy) , placebo , radiation therapy , nuclear medicine , cardiology , surgery , percutaneous coronary intervention , myocardial infarction , pathology , alternative medicine
The relation between lesion length and effectiveness of gamma radiation treatment (γ‐RT) has not been well described. We evaluated the acute and long‐term outcome according to baseline lesion length in 130 patients treated with 192 Ir in the Washington Radiation for In‐Stent Restenosis Trial; 44 (35.5%) had baseline short in‐stent restenosis (ISR) lesions (length < 15 mm) and 80 (64.5%) long ISR lesions (length ≥ 15 mm). At 6‐month follow‐up after γ‐RT, the short ISR group had larger lumen dimensions and lower late loss than the long ISR group. Restenosis rate was significantly higher in patients with long ISR for both the placebo (74% vs. 39%; P = 0.01) and the γ‐RT arm (31% vs. 5.3%; P = 0.04). γ‐RT significantly improved the angiographic outcome in the short‐lesion groups but had the more pronounced effect on the reduction of clinical events after treatment of long ISR group. Lesion length remains a powerful predictor of recurrent ISR and clinical events after treatment of ISR even with γ‐RT. Catheter Cardiovasc Interv 2004;61:354–359. © 2004 Wiley‐Liss, Inc.