Long-term clinical outcome of patients treated with beta-brachytherapy in routine clinical practice (Journal article)
Nikas, D. N./ Kalef-Ezra, J./ Katsouras, C. S./ Tsekeris, P./ Bozios, G./ Pappas, C./ Naka, K. K./ Kotsia, A./ Papamichael, N./ Sideris, D. A./ Michalis, L. K.
Background: Only limited data exist regarding the long-term efficacy of beta-brachytherapy (beta-VBT) in routine clinical practice and the impact of the prolonged (> 6 months) combined antiplatelet therapy after beta-VBT. Our aim is to examine the long-term clinical efficacy of routine beta brachytherapy (beta-VBT) followed by indefinite administration of combined antiplatelet therapy in patients at high restenotic risk. Methods: Sixty-one patients with 65 lesions [de novo: 41, in-stent restenotic (ISR): 24] underwent intracoronary beta-VBT and were followed prospectively. All patients received indefinite administration of aspirin and clopidogrel, underwent routine angiography 6 months later and were followed-up clinically for 43.7 months (range: 32 to 52 months). Results: Acute success was achieved in 60/61 (98.4%) patients. Lesion length was 36.1 (+/- 17.6) mm for the de novo and 22.0 (+/- 9.8) mm for the ISR (p=0.001). Stems were implanted in 35/41 de novo and 7/24 ISR lesions (p < 0.01). Six-month binary restenosis after successful beta-VBT was 35.9% (23/64). During follow-up patients with de-novo lesions who received a new stent during index procedure had a higher incidence of major cardiac events than patients with ISR lesions without a new stent (log rank test, p=0.02). Acute and late thrombotic events were reported at 6 patients, all with de novo lesions and stent implantation. Conclusions: Beta-VBT plus stenting in de novo lesions is related to an unacceptable high rate of thrombotic complications and clinical restenosis despite prolonged administration of combined antiplatelet therapy. Brachytherapy remains a reasonable option for patients with ISR lesions until full data from large randomized trials comparing drug eluting stents with brachytherapy are available. (c) 2006 Elsevier Ireland Ltd. All rights reserved.
|Institution and School/Department of submitter:||Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών και Τεχνολογιών. Τμήμα Βιολογικών Εφαρμογών και Τεχνολογιών|
|Keywords:||percutaneous coronary interventions,beta-brachytherapy,intravascular brachytherapy,in-stent restenosis,intracoronary gamma-radiation,catheter-based radiotherapy,2-year follow-up,intravascular ultrasound,coronary restenosis,washington radiation,balloon angioplasty,late thrombosis,wrist-plus|
|Link:||<Go to ISI>://000244512800008|
|Appears in Collections:||Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)|
Files in This Item:
|Nikas-2007-Long-term clinical o.pdf||132.52 kB||Adobe PDF||View/Open Request a copy|
Please use this identifier to cite or link to this item:This item is a favorite for 0 people.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.