Three-Year Clinical Follow-up Results of Intracoronary Radiation Therapy Using a Rhenium-188-Diethylene-Triamine-Penta-Acetic-Acid-Filled Balloon System
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概要
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Background Intracoronary radiation therapy (IRT) prevents recurrent in-stent restenosis, but its long-term safety and efficacy remain uncertain. In the present study, the long-term clinical outcome of IRT using the rhenium-188 (^<188>Re)-filled balloon system was evaluated. Methods and Results After successful catheter-based treatment of either a de novo or restenotic lesion, 187 patients were randomly assigned to either the radiation (N=104) or the control (N=83) group. The ^<188>Re-filled balloon system was designed to deliver 17.6 Gy to 1.0-mm tissue depth. Angiographic restenosis was significantly reduced with IRT at 9 months (18.9% vs 45.9%, p<0.001), but the incidence of major adverse cardiac events (MACE) including death, myocardial infarction, and target-vessel revascularization (TVR) by 3 years showed no difference. Lack of clinical benefit might be related to TVR caused by geographic miss (6/22, 28.6%), balloon-induced unhealed dissection (3/22, 13.6%) and late thrombosis (2/22, 9. 1 %). In the restenotic subgroup (N=39), the MACE rate within 3 years was significantly reduced with IRT (14.3% vs 54.5%, p=0.01). Conclusions IRT using the 188Re -filled balloon system is safe and technically feasible. Although IRT failed to show favorable outcomes for de novo lesion, the clinical benefits for restenotic lesions seem durable for 3 years. Furthermore, preventing geographic miss and dissection might improve long-term outcomes.
- 社団法人日本循環器学会の論文
- 2004-05-20
著者
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Kang Hyun-Jae
Cardiovascular Center, Seoul National University Hospital
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Koo Bon-Kwon
Cardiovascular Center, Seoul National University Hospital
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Chae In-Ho
Cardiovascular Center, Seoul National University Bundang Hospital
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Kim Hyo-Soo
Cardiovascular Center, Seoul National University Hospital
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Koo Bon-kwon
Seoul National University Hospital
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Koo Bon
Heart Center Of Chonnam National University Hospital
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Youn Tae-jin
韓国
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Youn T‐j
Bundang Hospital College Of Medicine Seoul National University
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Yeon Tae-jin
韓国
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Park Kyung
Department Of Laboratory Medicine Seoul National University College Of Medicine:seoul National Unive
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Park Kyung-woo
韓国
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Kim H‐s
Seoul National University Hospital
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Kim Hyo-soo
韓国
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Kim Hyo-soo
Seoul National University Hospital
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Kim Sang-hyun
Department Of Internal Medicine Cardiovascular Center Seoul National University Hospital:seoul Natio
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Park Keun-Ho
Seoul National University Hospital
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Oh Byung-Hee
Seoul National University Hospital
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Youn Tae-Jin
Cardiovascular Center, Seoul National University Bundang Hospital
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Kim Hyung-Kwan
Seoul National University Hospital
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Chae In-ho
Bundang Hospital College Of Medicine Seoul National University
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Choi Yun
Department Of Internal Medicine Seoul National University College Of Medicine
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Cho Young-seok
Bundang Hospital College Of Medicine Seoul National University
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Kang Hyun-jae
韓国
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Kang H‐j
Seoul National University Hospital
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Oh B‐h
Seoul National University Hospital
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Oh Byung-hee
韓国
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Park Young-bae
韓国
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Park Y‐b
Division Of Cardiology Department Of Internal Medicine Seoul National University College Of Medicine
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Kim Kwang-il
Department Of Internal Medicine Seoul National University College Of Medicine Seoul National Univers
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Cho Young-seok
Department Of Internal Medicine Seoul National University College Of Medicine Seoul National Univers
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Youn Tae-jin
Department Of Cardiology Chungbuk National University Hospital
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Kim Kwang-il
Seoul National University Bundang Hospital
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Park Keun-ho
Department Of Laboratory Medicine Seoul National University College Of Medicine:seoul National Unive
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Park Keun-ho
韓国
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Sohn Dae-won
Division Of Cardiology Department Of Internal Medicine Seoul National University College Of Medicine
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PARK Kyung-Woo
Jeju self-government province
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CHO Young-Seok
Jeju self-government province
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KIM Hyo-Soo
Jeju self-government province
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Kim Sang-hyun
Cardiovascular Center Seoul National University Hospital
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Park Kyung
韓国
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Park Hyo
韓国
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Kim Kwang-Il
Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul National Unive
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Bae Jangwhan
Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul National Unive
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Sohn Dae-Won
Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul National Unive
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Oh Byung-Hee
Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul National Unive
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Lee Myoung-Mook
Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul National Unive
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Park Young-Bae
Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul National Unive
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Choi Yun-Shik
Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul National Unive
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Lee Dong-Soo
Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul National Unive
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Lee Myoung-mook
韓国
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Lee M‐m
Seoul National University Hospital
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Lee Myoung-mook
Division Of Cardiology Department Of Internal Medicine Seoul National University College Of Medicine
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Park Young-bae
Division Of Cardiology Department Of Internal Medicine College Of Medicine Seoul National University
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Chae In-ho
Seoul National University College Of Medicine Cardiovascular Center Seoul National University Bundan
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Kim Kwang-il
Department Of Internal Medicine Seoul National University College Of Medicine
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Oh Byung-hee
Division Of Cardiology Department Of Internal Medicine College Of Medicine Seoul National University
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Park Young
Division Of Cardiology Department Of Internal Medicine College Of Medicine Seoul National University
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Bae Jangwhan
Seoul National University Hospital
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Lee Dong-soo
Cardiovascular Center Division Of Cardiology Department Of Internal Medicine Seoul National Universi
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Chae In-ho
Cardiovascular Center Seoul National University Hospital
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Kim Kwang-il
Cardiovascular Center And Department Of Internal Medicine Seoul National University Hospital
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Lee Myoung-mook
Department Of Internal Medicine Seoul National University College Of Medicine:cardiovascular Lab Cli
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Kim Hyo-soo
Cardiovascular Center And Department Of Internal Medicine Seoul National University Hospital
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Park K‐w
Jeju Self-government Province
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Kang Hyun-jae
Cardiovascular Center Seoul National University Main Hospital
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Koo Bon-kwon
Cardiovascular Center Seoul National University Main Hospital
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Cho Young-seok
Department Of Internal Medicine Seoul National University College Of Medicine Seoul National Univers
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Oh Byung-hee
Cardiovascular Center Seoul National University Main Hospital
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Cho Young-seok
Department Of Internal Medicine Seoul National University College Of Medicine Seoul National Univers
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Lee Myoung-mook
Cardiovascular Center Seoul National University Hospital
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Koo Bon-kwon
Cardiovascular Center Seoul National University Hospital
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