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50th Annual Scientific Session of the American College of Cardiology, March 2001, Orlando, Florida
- Long Lesions Treated Using Sr/Y90 Source Trains, a Subanalysis of RENO: A European Surveillance Registry With the Novoste Beta-Cath System
- A. Colombo (1), G. Stankovic (1), P. Serruys (2), T. Schiele (3), E. Eeckhout (4), S. Silber (5), R. Bonan (6), P. Urban (7)
- 1, EMO Centro Cuore Columbus, Milano, Italy
- 2, Heart Center Rotterdam, the Netherlands
3, Medizinische Klinik Innenstadt, Munich, Germany- 4, CHUV, Lausanne, Switzerland
- 5, Dr. Mueller Hospital, Munich, Germany
- 6, Montreal Heart Institute, Canada
- 7, La Tour Hospital, Geneva, Switzerland
- J Am Coll Cardiol, 37, 28-A (2001)
The Reno Registry has been established to keep track of all patients undergoing Beta-Cath brachytherapy not suitable for inclusion in any Beta-Cath trial. 477 patients have been included so far in this Registry. In 76 of these patients brachytherapy was delivered with the pullback technique due to the length of the lesion to be treated.
This report presents the acute and follow-up data of these 76 patients in whom 87 lesions were treated with this technique (1.14 lesion/patient).
Mean age was 61.78±9.68 years and 63 were male (82.9%). Sixteen patients (21.3%) had diabetes and 19 (27.9%) had unstable angina.
One vessel was treated in 66 patients, two vessels in 9 patients, and three vessels in 1 patient. 83 lesions were located in native coronary arteries and 4 in by-pass grafts. 30 lesions were de novo, 2 were restenotic, and 55 were in-stent restenosis. Reference vessel size was 3.21±0.52 mm and mean lesion length was 31.68±18.82 mm.
Radiation treatment was performed utilizing a 30 mm (25.6% of lesions) or 40 mm (74.6% of lesions) long source train, with a mean dwell time of 3.68±1.35 min delivering. Procedures were successful in 80 lesions (94.1%). Stents were implanted in 52 lesions (59.8%). Obvious geographic miss occurred in 8 lesions (9.4%).
In-hospital outcome: Two patients (2.6%) had myocardial infarction, and two patients (2.6%) had repeat PTCA. There were no deaths or CABG. At 6-month follow-up the incidence of MACEs (including in-hospital events) was 18.4%. Twelve patients (15.8%) underwent repeat revascularization (11 had rePTCA and 1 had CABG). Two patients died (2.6%).Conclusions: these preliminary results seem to support the fact that the pullback technique can be safely performed with this beta delivery system. The follow-up events appear low considering the length of the lesions treated and the high incidence of in-stent restenosis in the baseline population.
