Long-term Angiographic and Clinical Outcome After Percutaneous Transluminal Coronary Angioplasty and Intracoronary Radiation Therapy in Humans
Autor: | Ian R. Crocker, Raul E. Espinosa, Ron Waksman, Ki Bae Seung, Orlando Gurdiel, Harry Acquatella, Samuel F. Liprie, Bruno Burger, Juan José Ramos González, Guillermo Villoria, Jose A. Condado |
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Rok vydání: | 1997 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Brachytherapy Coronary Disease Coronary Angiography Balloon Cohort Studies Restenosis Recurrence Physiology (medical) Internal medicine Angioplasty medicine Humans Angina Unstable Angioplasty Balloon Coronary Aged medicine.diagnostic_test Unstable angina Vascular disease business.industry Middle Aged medicine.disease Coronary Vessels Survival Analysis Coronary arteries Stenosis Treatment Outcome medicine.anatomical_structure Angiography Cardiology Feasibility Studies Female Radiology Cardiology and Cardiovascular Medicine business Follow-Up Studies |
Zdroj: | Scopus-Elsevier |
ISSN: | 1524-4539 0009-7322 |
Popis: | Background Ionizing radiation has been shown to reduce neointimal formation after balloon angioplasty in experimental models of restenosis. This study was designed to evaluate the feasibility, safety, and effectiveness of intracoronary radiation therapy (ICRT) after percutaneous transluminal coronary angioplasty (PTCA) for preventing restenosis in human coronary arteries. Methods and Results Twenty-one patients (22 arteries) with unstable angina underwent standard balloon angioplasty. ICRT was performed with the use of an 192 Ir source wire that was hand delivered to the angioplasty site. Angiographic follow-up was performed at 24 hours, between 30 and 60 days, and at 6 months. Angioplasty was successful in 19 of 22 lesions, and insertion of the radioactive source wire was successful at all treated sites. Angiographic study at 24 hours demonstrated early late loss of the luminal diameter from 1.92±0.55 to 1.40±0.27 mm. Between 30 and 60 days, repeat angiography demonstrated total occlusion in 2 arteries, a new pseudoaneurysm in 1 artery, and significant dilatation at the treatment site in 2 additional vessels. At ≥6 months’ follow-up, all remaining arteries (n=20) maintained patent, with a mean lumen diameter of 1.65±0.8 mm. The calculated late lumen loss was 0.27±0.56 mm, and the late loss index was 0.19. Clinical events at 1 year included myocardial infarction in 1 patient, repeat angioplasty to the treated site in 3 patients, and persistent angina in 7 patients. Conclusions These preliminary results demonstrate that ICRT after coronary intervention is feasible and is associated with an acceptable degree of complications and lower rates of angiographic restenosis indexes. |
Databáze: | OpenAIRE |
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