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74th Scientific Sessions of the American Heart Association (AHA), November 2001, Anaheim, California
- Intracoronary radiation therapy for the treatment of small (< 2.75 mm) vessels: results from a large, prospective, multicentric, European registry (RENO).
- Dietrich Baumgart, Christoph K Naber, University of Essen, Essen Germany; Sigmund Silber, Klinik Dr. Mueller, Munich, Munich Germany; Thomas M Schiele, Klinikum Innenstadt, Munich, Muenchen Germany; Wolfgang Auch-Schwelk, University of Frankfurt, Frankfurt Germany; Phillip Urban, Centre Hospitalier Universitaire Vaudois, Lausanne, Lausanne Switzerland
- Circulation, 104, II-577 (2001)
Introduction: Interventions in small vessels are at a dramatically increased risk of restenosis and vessel occlusions. The most promising development in the field of coronary interventions is the application of intracoronary radiation which demonstrated a significant reduction of the restenosis rate in several high risk populations.
Methods: 1124 patients were included in 43 European centers. In these patients 1160 lesions were treated by percutaneous angioplasty and additional irradiation utilizing the Novoste Beta-Cath™ system consisting of a Sr/Y90-source train of 30, 40 or 60mm length, respectively.
Results: 173 lesions (14.9%) were located in vessels with a reference diameter of 2.75 mm or less. Mean reference diameter was 2.5±0.3 vs. 3.3±0.4 mm. Lesion length was comparable (18.1±10.2 vs. 19.4±12.3 mm). Radiation dose was expectedly lower in the small vessels (16.8±2.5 vs. 19.5±3.1 Gy). Current 6-months follow up includes 136 patients with target lesions located in small vessels and 591 patients with lesions in larger vessels. Angiographic restenosis rate (18.9 vs. 24.7%;n.s.) and overall MACE rate (16.9 vs. 21.3%;n.s.) and target vessel revascularization (TVR) after 6 months (14.7 vs. 19.1%; n.s.) were not different between the investigated groups.
Conclusions: In comparison with previous trials, the treatment of target lesions located in small vessels demonstrated an improved outcome after additional intracoronary irradiation.
