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Predictors of recurrent in-stent restenosis after beta-radiation: An analysis from the START 40/20 trial.

Abstract：

OBJECTIVE:The purpose of this study was to identify potential predictors, including clinical, procedural, angiographic, and intravascular ultrasound (IVUS) parameters, for recurrent in-stent restenosis (ISR) following beta-radiation 90Strontium/Yttrium (90Sr/Y) in a large multicenter trial. BACKGROUND:Although adjunct brachytherapy reduces recurrent ISR after primary catheter-based intervention, recurrence of stenosis after brachytherapy still occurs. METHODS:We analyzed 185 IVUS cohort patients in the STent And Restenosis Therapy (START) 40/20 trial where a 40-mm, 90Sr/Y, radioactive source train was exclusively used for treatment of ISR to be treatable with a 20-mm balloon. RESULTS:Thirty-nine patients underwent target lesion revascularization. Preliminary univariate analysis showed that age, smoking, balloon/artery ratio, geographic miss, minimum lumen diameter, and diameter stenosis at baseline were associated with target lesion revascularization, while none of IVUS variables were (minimum lumen area, minimum stent area, or residual plaque burden). The multivariate logistic regression analysis showed that younger age, lower balloon/artery ratio, and presence of geographic miss were independent predictors of target lesion revascularization. CONCLUSIONS:Even with adjunct beta-radiation therapy, initial mechanical optimization, such as appropriate balloon sizing and positioning, may be critical for the prevention of recurrent ISR.

journal_name

J Interv Cardiol

journal_title

Journal of interventional cardiology

authors

Kaneda H,Honda Y,Morino Y,Lansky AJ,Yock PG,Bonan R,Fitzgerald PJ

doi

10.1111/j.1540-8183.2006.00188.x

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

376-80

issue

5

eissn

0896-4327

issn

1540-8183

pii

JOIC188

journal_volume

19

pub_type

杂志文章,多中心研究

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