Serial intravascular ultrasound analysis of the impact of lesion length on the efficacy of intracoronary γ-irradiation for preventing recurrent In-Stent Restenosis
The relation between lesion length and effectiveness of brachytherapy is not well studied. We compared serial (postintervention and follow-up) intravascular ultrasound findings in 66 patients with native coronary artery in-stent restenosis (ISR) who were treated with (192)Ir (15 Gy delivered 2 mm aw...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2001-01, Vol.103 (2), p.188-191 |
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| creator | AHMED, Javed M MINTZ, Gary S WAKSMAN, Ron WEISSMAN, Neil J LEIBOFF, Borjanka PICHARD, Augusto D SATLER, Lowell F KENT, Kenneth M LEON, Martin B |
| description | The relation between lesion length and effectiveness of brachytherapy is not well studied.
We compared serial (postintervention and follow-up) intravascular ultrasound findings in 66 patients with native coronary artery in-stent restenosis (ISR) who were treated with (192)Ir (15 Gy delivered 2 mm away from the radiation source). Patients were enrolled in the Washington Radiation for In-Stent Restenosis Trial (WRIST; ISR length, 10 to 47 mm; n=36) or Long WRIST (ISR length, 36 to 80 mm; n=30). External elastic membrane, stent, lumen, and intimal hyperplasia (IH; stent minus lumen) areas and source-to-target (intravascular ultrasound catheter to external elastic membrane) distances were measured. Postintervention stent areas were larger in WRIST and smaller in Long WRIST patients (P: |
| doi_str_mv | 10.1161/01.CIR.103.2.188 |
| format | Article |
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We compared serial (postintervention and follow-up) intravascular ultrasound findings in 66 patients with native coronary artery in-stent restenosis (ISR) who were treated with (192)Ir (15 Gy delivered 2 mm away from the radiation source). Patients were enrolled in the Washington Radiation for In-Stent Restenosis Trial (WRIST; ISR length, 10 to 47 mm; n=36) or Long WRIST (ISR length, 36 to 80 mm; n=30). External elastic membrane, stent, lumen, and intimal hyperplasia (IH; stent minus lumen) areas and source-to-target (intravascular ultrasound catheter to external elastic membrane) distances were measured. Postintervention stent areas were larger in WRIST and smaller in Long WRIST patients (P:<0.0001). At follow-up, maximum IH area significantly increased in both WRIST and Long WRIST patients (P:<0.0001 for both), but this increase was greater in Long WRIST patients (P:=0.0006). Similarly, minimum lumen cross-sectional area significantly decreased in both WRIST and Long WRIST patients (P:<0.05 and P:<0.0001, respectively), but this decrease was more pronounced in Long WRIST patients (P:=0.0567). The maximum source-to-target distance was longer in Long WRIST than in WRIST, and it correlated directly with ISR length (r=0.547, P:<0.0001). Overall, the change in minimum lumen area and the change in maximum IH area correlated with the maximum source-to-target distance (r=0.352, P:=0.0038 and r=0.523, P:<0.0001 for WRIST and Long WRIST, respectively). The variability (maximum/minimum) in IH area at follow-up also correlated with the maximum source-to-target distance (r=0.378, P:<0.0001).
Brachytherapy may be less effective in longer ISR lesions because of the greater variability and longer source-to-target distances in diffuse ISR.]]></description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.103.2.188</identifier><identifier>PMID: 11208674</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Biological and medical sciences ; Brachytherapy - standards ; Coronary Restenosis - prevention & control ; Coronary Stenosis - diagnostic imaging ; Coronary Stenosis - prevention & control ; Coronary Stenosis - radiotherapy ; Coronary Vessels - diagnostic imaging ; Diseases of the cardiovascular system ; Follow-Up Studies ; Gamma Rays - therapeutic use ; Humans ; Hyperplasia ; Iridium Radioisotopes - therapeutic use ; Medical sciences ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Randomized Controlled Trials as Topic ; Stents ; Treatment Outcome ; Tunica Intima - diagnostic imaging ; Ultrasonography, Interventional - methods</subject><ispartof>Circulation (New York, N.Y.), 2001-01, Vol.103 (2), p.188-191</ispartof><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c297t-8a42d1da05daf842a1191eb0e19aeac6c68c782704489b9f3ec35c6e8d70392b3</citedby><cites>FETCH-LOGICAL-c297t-8a42d1da05daf842a1191eb0e19aeac6c68c782704489b9f3ec35c6e8d70392b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,780,784,789,790,3685,23929,23930,25139,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=865323$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11208674$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>AHMED, Javed M</creatorcontrib><creatorcontrib>MINTZ, Gary S</creatorcontrib><creatorcontrib>WAKSMAN, Ron</creatorcontrib><creatorcontrib>WEISSMAN, Neil J</creatorcontrib><creatorcontrib>LEIBOFF, Borjanka</creatorcontrib><creatorcontrib>PICHARD, Augusto D</creatorcontrib><creatorcontrib>SATLER, Lowell F</creatorcontrib><creatorcontrib>KENT, Kenneth M</creatorcontrib><creatorcontrib>LEON, Martin B</creatorcontrib><title>Serial intravascular ultrasound analysis of the impact of lesion length on the efficacy of intracoronary γ-irradiation for preventing recurrent In-Stent Restenosis</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description><![CDATA[The relation between lesion length and effectiveness of brachytherapy is not well studied.
We compared serial (postintervention and follow-up) intravascular ultrasound findings in 66 patients with native coronary artery in-stent restenosis (ISR) who were treated with (192)Ir (15 Gy delivered 2 mm away from the radiation source). Patients were enrolled in the Washington Radiation for In-Stent Restenosis Trial (WRIST; ISR length, 10 to 47 mm; n=36) or Long WRIST (ISR length, 36 to 80 mm; n=30). External elastic membrane, stent, lumen, and intimal hyperplasia (IH; stent minus lumen) areas and source-to-target (intravascular ultrasound catheter to external elastic membrane) distances were measured. Postintervention stent areas were larger in WRIST and smaller in Long WRIST patients (P:<0.0001). At follow-up, maximum IH area significantly increased in both WRIST and Long WRIST patients (P:<0.0001 for both), but this increase was greater in Long WRIST patients (P:=0.0006). Similarly, minimum lumen cross-sectional area significantly decreased in both WRIST and Long WRIST patients (P:<0.05 and P:<0.0001, respectively), but this decrease was more pronounced in Long WRIST patients (P:=0.0567). The maximum source-to-target distance was longer in Long WRIST than in WRIST, and it correlated directly with ISR length (r=0.547, P:<0.0001). Overall, the change in minimum lumen area and the change in maximum IH area correlated with the maximum source-to-target distance (r=0.352, P:=0.0038 and r=0.523, P:<0.0001 for WRIST and Long WRIST, respectively). The variability (maximum/minimum) in IH area at follow-up also correlated with the maximum source-to-target distance (r=0.378, P:<0.0001).
Brachytherapy may be less effective in longer ISR lesions because of the greater variability and longer source-to-target distances in diffuse ISR.]]></description><subject>Biological and medical sciences</subject><subject>Brachytherapy - standards</subject><subject>Coronary Restenosis - prevention & control</subject><subject>Coronary Stenosis - diagnostic imaging</subject><subject>Coronary Stenosis - prevention & control</subject><subject>Coronary Stenosis - radiotherapy</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Diseases of the cardiovascular system</subject><subject>Follow-Up Studies</subject><subject>Gamma Rays - therapeutic use</subject><subject>Humans</subject><subject>Hyperplasia</subject><subject>Iridium Radioisotopes - therapeutic use</subject><subject>Medical sciences</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Stents</subject><subject>Treatment Outcome</subject><subject>Tunica Intima - diagnostic imaging</subject><subject>Ultrasonography, Interventional - methods</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkcGKFDEURYMoTju6dyUBwV2VeUlVJbWUZtSGAWFG1-F1KpmJpJM2qRro__EP_A-_yZTT6Oq-S859j3AJeQ2sBRjgPYN2u7tpgYmWt6DUE7KBnndN14vxKdkwxsZGCs4vyItSvlc7CNk_JxcAnKlBdhvy89Zmj4H6OGd8wGKWgJkuobqSljhRjBhOxReaHJ3vLfWHI5p5dcEWn2KVeDff0zqtz9Y5b9CcVuDvTpNyiphP9PevxueMk8d5jbmU6THbBxtnH-9otmbJuRq6i83tvA43tlRN9fZL8sxhKPbVWS_Jt49XX7efm-svn3bbD9eN4aOcG4Udn2BC1k_oVMcRYAS7ZxZGtGgGMygjFZes69S4H52wRvRmsGqSTIx8Ly7Ju8e9x5x-LPW8PvhibAgYbVqKliCGXkJXQfYImpxKydbpY_aH-ksNTK_NaAa6NlOt0FzXZmrkzXn3sj_Y6X_gXEUF3p6B2gIGlzEaX_5xaugFF-IP7jabXg</recordid><startdate>20010116</startdate><enddate>20010116</enddate><creator>AHMED, Javed M</creator><creator>MINTZ, Gary S</creator><creator>WAKSMAN, Ron</creator><creator>WEISSMAN, Neil J</creator><creator>LEIBOFF, Borjanka</creator><creator>PICHARD, Augusto D</creator><creator>SATLER, Lowell F</creator><creator>KENT, Kenneth M</creator><creator>LEON, Martin B</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010116</creationdate><title>Serial intravascular ultrasound analysis of the impact of lesion length on the efficacy of intracoronary γ-irradiation for preventing recurrent In-Stent Restenosis</title><author>AHMED, Javed M ; MINTZ, Gary S ; WAKSMAN, Ron ; WEISSMAN, Neil J ; LEIBOFF, Borjanka ; PICHARD, Augusto D ; SATLER, Lowell F ; KENT, Kenneth M ; LEON, Martin B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c297t-8a42d1da05daf842a1191eb0e19aeac6c68c782704489b9f3ec35c6e8d70392b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Biological and medical sciences</topic><topic>Brachytherapy - standards</topic><topic>Coronary Restenosis - prevention & control</topic><topic>Coronary Stenosis - diagnostic imaging</topic><topic>Coronary Stenosis - prevention & control</topic><topic>Coronary Stenosis - radiotherapy</topic><topic>Coronary Vessels - diagnostic imaging</topic><topic>Diseases of the cardiovascular system</topic><topic>Follow-Up Studies</topic><topic>Gamma Rays - therapeutic use</topic><topic>Humans</topic><topic>Hyperplasia</topic><topic>Iridium Radioisotopes - therapeutic use</topic><topic>Medical sciences</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Stents</topic><topic>Treatment Outcome</topic><topic>Tunica Intima - diagnostic imaging</topic><topic>Ultrasonography, Interventional - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>AHMED, Javed M</creatorcontrib><creatorcontrib>MINTZ, Gary S</creatorcontrib><creatorcontrib>WAKSMAN, Ron</creatorcontrib><creatorcontrib>WEISSMAN, Neil J</creatorcontrib><creatorcontrib>LEIBOFF, Borjanka</creatorcontrib><creatorcontrib>PICHARD, Augusto D</creatorcontrib><creatorcontrib>SATLER, Lowell F</creatorcontrib><creatorcontrib>KENT, Kenneth M</creatorcontrib><creatorcontrib>LEON, Martin B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>AHMED, Javed M</au><au>MINTZ, Gary S</au><au>WAKSMAN, Ron</au><au>WEISSMAN, Neil J</au><au>LEIBOFF, Borjanka</au><au>PICHARD, Augusto D</au><au>SATLER, Lowell F</au><au>KENT, Kenneth M</au><au>LEON, Martin B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serial intravascular ultrasound analysis of the impact of lesion length on the efficacy of intracoronary γ-irradiation for preventing recurrent In-Stent Restenosis</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2001-01-16</date><risdate>2001</risdate><volume>103</volume><issue>2</issue><spage>188</spage><epage>191</epage><pages>188-191</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract><![CDATA[The relation between lesion length and effectiveness of brachytherapy is not well studied.
We compared serial (postintervention and follow-up) intravascular ultrasound findings in 66 patients with native coronary artery in-stent restenosis (ISR) who were treated with (192)Ir (15 Gy delivered 2 mm away from the radiation source). Patients were enrolled in the Washington Radiation for In-Stent Restenosis Trial (WRIST; ISR length, 10 to 47 mm; n=36) or Long WRIST (ISR length, 36 to 80 mm; n=30). External elastic membrane, stent, lumen, and intimal hyperplasia (IH; stent minus lumen) areas and source-to-target (intravascular ultrasound catheter to external elastic membrane) distances were measured. Postintervention stent areas were larger in WRIST and smaller in Long WRIST patients (P:<0.0001). At follow-up, maximum IH area significantly increased in both WRIST and Long WRIST patients (P:<0.0001 for both), but this increase was greater in Long WRIST patients (P:=0.0006). Similarly, minimum lumen cross-sectional area significantly decreased in both WRIST and Long WRIST patients (P:<0.05 and P:<0.0001, respectively), but this decrease was more pronounced in Long WRIST patients (P:=0.0567). The maximum source-to-target distance was longer in Long WRIST than in WRIST, and it correlated directly with ISR length (r=0.547, P:<0.0001). Overall, the change in minimum lumen area and the change in maximum IH area correlated with the maximum source-to-target distance (r=0.352, P:=0.0038 and r=0.523, P:<0.0001 for WRIST and Long WRIST, respectively). The variability (maximum/minimum) in IH area at follow-up also correlated with the maximum source-to-target distance (r=0.378, P:<0.0001).
Brachytherapy may be less effective in longer ISR lesions because of the greater variability and longer source-to-target distances in diffuse ISR.]]></abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>11208674</pmid><doi>10.1161/01.CIR.103.2.188</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 2001-01, Vol.103 (2), p.188-191 |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Biological and medical sciences Brachytherapy - standards Coronary Restenosis - prevention & control Coronary Stenosis - diagnostic imaging Coronary Stenosis - prevention & control Coronary Stenosis - radiotherapy Coronary Vessels - diagnostic imaging Diseases of the cardiovascular system Follow-Up Studies Gamma Rays - therapeutic use Humans Hyperplasia Iridium Radioisotopes - therapeutic use Medical sciences Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Randomized Controlled Trials as Topic Stents Treatment Outcome Tunica Intima - diagnostic imaging Ultrasonography, Interventional - methods |
| title | Serial intravascular ultrasound analysis of the impact of lesion length on the efficacy of intracoronary γ-irradiation for preventing recurrent In-Stent Restenosis |
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