Korean Circ J.
2005 Aug;35(8):591-596. 10.4070/kcj.2005.35.8.591.
Effect of Vascular BRAchytherapy using HolmiuM-166 Liquid Balloon System after Cutting Balloon Angioplasty in Patients with Stent Restenosis(BRAHMS Study)
- Affiliations
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- 1Department of Cardiology, Dong-A Medical College, Busan, Korea. kmh60@damc.or.kr
- 2Department of Nuclear Medicine, Dong-A Medical College, Busan, Korea.
- 3Department of Radiation Oncology, Dong-A Medical College, Busan, Korea.
- 4ASCIRI (Atherosclerosis and Cardiovascular Intervention Research Institute), Dong-A Medical College, Busan, Korea.
- 5Department of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
- 6Department of Cardiology, Sungkyunkwan University College of Medicine, Seoul, Korea.
- 7Department of Cardiology, Youngnam University College of Medicine, Daegu, Korea.
- 8Department of Cardiology, Chonnam University College of Medicine, Gwangju, Korea.
- KMID: 2093945
- DOI: http://doi.org/10.4070/kcj.2005.35.8.591
Abstract
- BACKGROUND AND OBJECTIVES
Vascular brachytherapy for stent restenosis has been demonstrated to reduce restenosis and major adverse cardiac events (MACE). However, the angiographic and clinical outcomes after beta-radiation, using a 166Holmium (Ho)-DTPA filled balloon, has not been sufficiently evaluated.
SUBJECTS AND METHODS
Between March 2002 and August 2003, 78 consecutive patients (mean age 50 yrs, 53 male) with in-stent restenosis were randomly enrolled for either cutting balloon angioplasty only (control group, n=38) or in combination with vascular brachytherapy using a 166Ho-DTPA filled balloon (brachytherapy group, n=40). The radiation dose applied was 18 Gy, at a depth of 1.0 mm from the vascular lumen.
RESULTS
The treated vessels comprised of 50 left anterior descending arteries (64.1%), 23 right coronary arteries (29.5%) and 5 circumflex arteries. The mean radiation dose and time were 375+/-67.8 mCi/ml and 191+/-76 seconds, respectively. Six cases were fractionated. The mean lesion length was 18.2+/-7.9 mm, with no difference between the 2 groups. Eight month follow-up coronary angiography revealed a restenosis rate of 17.1% (6/35) in the brachytherapy group vs. 39.3% (11/27) in the control group (p=0.042). However, there was no difference in the 1 year MACE.
CONCLUSION
In patients with in-stent restenosis, vascular brachytherapy, using a 166Ho-DTPA filled balloon, showed favorable angiographic outcomes at the 8 month follow-up compared to the control group.
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