Rotational atherectomy or balloon angioplasty in the treatment of intra-stent restenosis: BARASTER Multicenter Registry

Goldberg, Steven L.; Berger, Peter B.; Cohen, David J.; Shawl, Fayaz A.; Buchbinder, Maurice; Fortuna, Richard; O’Neill, William; Leon, Martin B.; Braden, Gregory A.; Teirstein, Paul S.; Reisman, Mark; Bailey, Steven R.; Dauerman, Harold L.; Bowers, Thomas A.; Mehran, R.; Colombo, Antonio

doi:10.1002/1522-726x(200012)51:4<407::aid-ccd7>3.0.co;2-4

Cited by 30 publications

(12 citation statements)

References 23 publications

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“…However, when the actual delivered dose to the target tissues was simulated, a considerable discrepancy was appreciated between the prescribed and delivered dose, 10 which necessitates precise investigations of vascular responses that are based on the actual delivered dose. Thus, the aims of the present study were to (1) investigate the relationship between the delivered dose and vascular changes individually by volumetric intravascular ultrasound (IVUS) analysis and (2) test the appropriateness of the current dose-prescription protocol for 90 Sr/Y radiation to native ISR lesions.…”

supporting

confidence: 88%

“…Although several aggressive strategies for ISR treatment, such as dilation and debulking, have altered late outcomes, the actual recurrent restenosis rates remain high. 1,2 Recently, intravascular brachytherapy (IVBT), as a potential antiproliferative treatment, has been applied to ISR and has demonstrated a striking reduction in recurrent restenosis. [3][4][5] This new technology has been approved and is currently being used worldwide.…”

mentioning

confidence: 99%

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Delivered Dose and Vascular Response After β-Radiation for In-Stent Restenosis

et al. 2002

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Background-Observations from previous intracoronary radiation therapy trials noted a considerable discrepancy between the prescribed radiation dose and the dose actually delivered. The aims of this study were to investigate the effect of actual delivered dose on vascular changes and to test the appropriateness of the current dose prescription. Methods and Results-Serial volumetric intravascular ultrasound (IVUS) analysis was performed in 30 in-stent restenosis cases treated with a 40-mm 90 Sr/Y source train. The fixed dose was prescribed at 2 mm from the centerline of the source train (18.4 Gy at 2 mm for reference diameter Յ3.35 mm and 23 Gy for diameter Ն3.36 mm). Only stent segments with full radiation coverage and device injury were enrolled and divided into 2-mm-long subsegments (nϭ202). D S90 EEM (the minimum dose absorbed by 90% of the external elastic membrane surface) was calculated as the delivered dose corresponding to each segment, assuming that the radiation catheter occupied the same position in the vessel as the IVUS catheter. Mean D S90 EEM of 23.5Ϯ5.82 Gy (range 12.3 to 41.7 Gy) was delivered to these subsegments. Overall, intimal hyperplasia volume remained constant from postintervention to follow-up (2.23Ϯ1.10 to 2.32Ϯ1.09 mm 3 /m; PϭNS). Regression analysis revealed there was no correlation between delivered dose intensity and changes in intimal hyperplasia volume. No particular dose-dependent complications were appreciated in this delivered dose range. Conclusions-The current dose-prescription protocol of 90 Sr/Y radiation to native in-stent restenosis lesions may provide substantial inhibition of neointimal reproliferation regardless of the actual delivered dose intensity.

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supporting

confidence: 88%

mentioning

confidence: 99%

Delivered Dose and Vascular Response After β-Radiation for In-Stent Restenosis

et al. 2002

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“…The findings of the various studies have created some general guiding rules for the optimized use of RotA (Brown et al, 1997;Reifart et al, 1997;Whitlow et al, 2001;Dill et al, 2000;Buchbinder et al, 2001;vom Dahl J et al, 2002;Goldberg et al, 2000):…”

Section: Rota-general Conceptsmentioning

confidence: 99%

Rotablation in the Drug Eluting Syent Era

Dardas¹

2012

Coronary Interventions

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“…Volumes were then divided by length to create an index (ie, stent, lumen, and IH volume index); results are reported as mm 2 . The axial variability in IH reaccumulation was assessed by calculating the coefficient of variation of the increase in IH for each segment by dividing mean IHϫ100 by the standard deviation of IH.…”

Section: Intravascular Ultrasound Imaging and Analysismentioning

confidence: 99%

“…1,2 Conversely, recent studies of adjunctive intravascular brachytherapy (IVBT) have shown a striking improvement in long-term outcomes. 3 4 5 In the early IVBT trials, late stent thrombosis occurred in 5% to 10% of patients and was associated with fresh stent deployment and early discontinuation of antiplatelet therapy.…”

mentioning

confidence: 99%

Late Vascular Response to Repeat Stenting for In-Stent Restenosis With and Without Radiation

Morino

Limpijankit²,

Honda³

et al. 2002

Circulation

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Background-Re-stenting of in-stent restenosis (ISR) improves acute angiographic results. Methods and Results-Volumetric intravascular ultrasound analysis was performed in 70 ISR lesions that received either placebo (nϭ36) or 192 Ir radiation (nϭ34). ISR lesions treated by re-stenting were divided into 3 groups: old stent not re-stented (A), old/new stent overlap (B), and new stent only (C). ISR lesions treated without re-stenting were categorized as D. In placebo patients, postintervention lumen volume index (LVI) was significantly greater in re-stented segments B and C than in non-re-stented segment A (PϽ0.05).At follow-up, however, LVI was similar in all 4 segments secondary to the increased intimal hyperplasia (IH) reaccumulation within the re-stented segments. In patients treated with 192 Ir radiation, LVI was maintained from baseline to follow-up only in non-re-stented segments A and D. Conversely, there was a significant decrease in LVI in re-stented segments B and C (PϽ0.05). Qualitatively, 79% of patients in the irradiated group had stent struts with undetectable neointimal versus only 27% in the placebo group (PϽ0.001). Coefficient of variation of IH reaccumulation was greater in re-stented segments of 192 Ir patients (Bϭ57.3% and Cϭ58.9%) than in re-stented segments in placebo patients (Bϭ27.3% and C 26.8%) and non-re-stented segments in irradiated patients. Conclusions-Additional

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Rotational atherectomy or balloon angioplasty in the treatment of intra-stent restenosis: BARASTER Multicenter Registry

Cited by 30 publications

References 23 publications

Delivered Dose and Vascular Response After β-Radiation for In-Stent Restenosis

Delivered Dose and Vascular Response After β-Radiation for In-Stent Restenosis

Rotablation in the Drug Eluting Syent Era

Late Vascular Response to Repeat Stenting for In-Stent Restenosis With and Without Radiation

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