Long-term clinical outcomes of newly implanted stents during intracoronary radiation.
- Author:
Jung Im SHIN
1
;
Sung Hwan KIM
;
Ii Young OH
;
Jung Ju SIR
;
Kwang Il KIM
;
Bon Kwon KOO
;
Myoung Mook LEE
;
In Ho CHAE
;
Myung A KIM
;
Hyo Soo KIM
;
Dae Won SOHN
;
Byung Hee OH
;
Young Bae PARK
;
Yun Shik CHOI
Author Information
1. Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. bkkoo@snu.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Restenosis;
Angioplasty;
Brachytherapy;
Stents
- MeSH:
Angioplasty;
Brachytherapy;
Catheters;
Follow-Up Studies;
Humans;
Rhenium;
Seoul;
Stents*;
Thrombosis;
Ticlopidine
- From:Korean Journal of Medicine
2004;67(5):480-487
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: New stent implantation during intracoronary brachytherapy is discouraged due to the high risk of late thrombosis. However, new stent implantation is inevitable in some cases due to the inadequate ballooning or major dissections. Long-term follow-up results of newly implanted stents during brachytherapy are not well-known. We performed this study to evaluate the long-term clinical outcomes of newly implanted stents during intracoronary brachytherapy. METHODS: In the Seoul national university Post-Angioplasty RhEnium irradiation (SPARE) trial, patients were treated with conventional catheter-based technique and then randomized to either beta- radiation (RG) or control group (CG). Radiation was performed with 188 -rhenium-filled conventional balloon catheter system. From 1999 to 2001, new stent implantation was performed in 58 and 56 patients in RG and CG, respectively. Clinical and angiographic follow up data were analyzed. RESULTS: In RG, short-term angiographic restenosis rate was lower than CG (28.6% vs 53%, p=0.03). In RG, late thrombosis was found in 3 patients. However, there was no late thrombosis in CG. Two year major cardiac event rates were not different between the 2 groups (RG: 25.9% vs CG: 28.3%). Independent predictors for major cardiac event in RG were major dissections (>or=type C) after stent implantation (beta=70, p=0.01) and longer administration of dual antiplatelets (aspirin+clopidogrel/ ticlopidine, >6 months, beta=0.07, p=0.04). CONCLUSION: Stenting during intracoronary brachytherapy seems to be ineffective in reducing long-term event rates. When new stent implantation is inevitable during brachytherapy, extreme attention is required not to make a dissection and long-term dual antiplatelet treatment should be followed after stent implantation.
