首页> 美国卫生研究院文献>British Heart Journal >Clinical and angiographic acute and follow up results of intracoronary β brachytherapy in saphenous vein bypass grafts: a subgroup analysis of the multicentre European registry of intraluminal coronary β brachytherapy (RENO)
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Clinical and angiographic acute and follow up results of intracoronary β brachytherapy in saphenous vein bypass grafts: a subgroup analysis of the multicentre European registry of intraluminal coronary β brachytherapy (RENO)

机译:大隐静脉旁路移植术中冠状动脉内β近距离治疗的临床和血管造影急性和随访结果:腔内冠状动脉β近距离治疗(RENO)的多中心欧洲注册研究的亚组分析

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摘要

>Objective: To assess clinically and angiographically the feasibility, safety, and effectiveness of vascular brachytherapy (VBT) in saphenous vein bypass grafts (SVG).>Patients and methods: 67 of 1098 (6.1%) consecutive patients of the European registry of intraluminal coronary β brachytherapy underwent treatment for 68 SVG lesions by VBT using a Sr/Y90 source train (BetaCath). Clinical follow up data were obtained for all of them after a mean (SD) of 6.3 (2.4) months and angiographic follow up was performed in 61 patients (91.0%) after 6.9 (2.0) months.>Results: 58 (86.6%) patients were men, their mean (SD) age was 66 (10) years, 28 (41.8%) had unstable angina, and 21 (31.3%) had diabetes. Fifty three (77.9%) lesions were in-stent restenosis, 13 (19.1%) de novo lesions, and 2 (3.0%) non-stented restenotic lesions. Mean (SD) reference diameter before the intervention was 4.19 (0.52) mm, mean (SD) lesion length was 23.56 (20.38) mm, and mean (SD) minimum lumen diameter measured 0.73 (0.62) mm. Mean (SD) acute gain was 3.02 (0.88) mm. The prescribed radiation dose was 20.1 (3.2) Gy. Pullback manoeuvres were performed in 17 (25.0%) of cases. Most patients received combined aspirin and thienopyridin treatment for 6 or 12 months after the procedure. Technical success was obtained in 62 (91.2%) treated lesions and in-hospital major adverse cardiac events occurred in 4.5%. At follow up, mean (SD) reference diameter was 4.20 (0.53) mm, minimum lumen diameter 2.94 (1.50) mm, and late loss 0.86 (1.25) mm. The overall major adverse cardiac events rate was 26.7%.>Conclusion: VBT of SVG is feasible and safe. At follow up the reintervention rate and cardiac morbidity and mortality seem to be favourable, considering that interventions in SVG usually are associated with the highest risks.
机译:>目的:在临床和血管造影术中评估大隐静脉旁路移植术(SVG)中进行血管近距离放射治疗(VBT)的可行性,安全性和有效性。>患者和方法: 1098年的67 (6.1%)欧洲人腔内冠状动脉β近距离放射疗法登记册的连续患者接受了Sr / Y 90 源训练(BetaCath)的VBT治疗68例SVG病变。在平均(SD)6.3(2.4)个月后获得所有患者的临床随访数据,在6.9(2.0)个月后对61例患者(91.0%)进行了血管造影随访。>结果: 58名(86.6%)男性患者,平均(SD)年龄为66(10)岁,28例(41.8%)患有不稳定型心绞痛,21例(31.3%)患有糖尿病。支架内再狭窄有53个(77.9%)病变,从头病变有13个(19.1%)和非支架再狭窄2个(3.0%)。干预前的平均(SD)参考直径为4.19(0.52)mm,平均(SD)病变长度为23.56(20.38)mm,平均(SD)最小内腔直径为0.73(0.62)mm。平均(SD)急性增高为3.02(0.88)mm。规定的辐射剂量为20.1(3.2)Gy。在17个案例中(25.0%)进行了回撤操作。大部分患者在手术后6或12个月接受阿司匹林和噻吩并吡啶联合治疗。在62个(91.2%)治疗的病灶中获得了技术成功,在医院内发生的严重不良心脏事件占4.5%。随访时,平均(SD)参考直径为4.20(0.53)mm,最小内腔直径为2.94(1.50)mm,晚期丢失为0.86(1.25)mm。总体主要不良心脏事件发生率为26.7%。>结论: SVG的VBT是可行且安全的。在随访中,考虑到SVG干预通常与最高风险相关,因此再干预率,心脏发病率和死亡率似乎是有利的。

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