Gamma radiation for in-stent restenosis: effect of lesion length on angiographic and clinical outcomes

✍ Scribed by Roxana Mehran; Ioannis Iakovou; George Dangas; Alexandra J. Lansky; Gregg W. Stone; Gary S. Mintz; Kenneth M. Kent; Augusto D. Pichard; Lowell F. Satler; Martin Fahy; Martin B. Leon; Ron Waksman

• Publisher: John Wiley and Sons
• Year: 2004
• Tongue: English
• Weight: 87 KB
• Volume: 61
• Category: Article
• ISSN: 1522-1946
• DOI: 10.1002/ccd.10786

✦ Synopsis

Abstract

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.