Radioaktiv betabestråling som adjuverende behandling af in-stent restenose i hjertets kranspulsårer
Sammanfattning
Introduction: The purpose of this study was to describe our initial "real-world" experience with vascular ß -radiation for in-stent restenosis using a simple angioplasty approach without stent implantation. Materials and methods: Thirty-five consecutive patients with in-stent restenosis were treated with balloon angioplasty (n = 28), cutting balloon angioplasty (n = 3), or angioplasty plus stent implantation (only in case of significant dissection: n = 4), followed by catheter-based ß -radiation. Angiographic follow-up was performed after 6 to 10 months. Results: One patient experienced a left main stem occlusion immediately after ß -radiation, which necessitated an acute coronary bypass operation. No other complications related to the radiation procedure were observed. In-stent restenosis recurred in 6 of the 34 patients (18%). Discussion: Our results indicate that catheter-based radiation can be safely introduced at centres without previous experience with this treatment modality. Furthermore, the in-stent restenosis recurrence rates after catheter-based radiation which have been obtained in randomised trials can be reproduced in consecutive patients.