β射线(^(90)Sr/^(90)Y)内照射治疗冠状动脉支架内再狭窄的疗效

Clinical effects of ^(90)Sr/^(90)Y beta-radiation intravascular brachytherapy for treatment of in-stent restenosis

目的 探讨 β射线 ( 90 Sr/90 Y)治疗冠状动脉支架内再狭窄的安全性和疗效。方法 40例经皮冠状动脉腔内成形术 (PCI)及支架置入术后再狭窄患者 ,随机分为支架内放射治疗组及单纯球囊组各 2 0例。病变经充分球囊扩张后 ,其中 2 0例随机 β射线血管腔内放射治疗 ,术后随访 9个月。 结果 单纯球囊组 8例研究段血管再狭窄 ( 4 0 % ) ,支架内放射治疗组有 2例再狭窄 ( 10 % ) ;两组间有显著性差异 ( χ2 =4.80 ,P <0 .0 5 )。结论 β射线 ( 90 Sr/90 Y)血管腔内放射治疗和预防冠状动脉支架内再狭窄是安全。

Objective To evaluate the safety and efficacy of a 40 mm strontium-90/yttrium-90 ( 90Sr/ 90Y) source train in the management of in-stent restenosis within native coronary arteries. Methods Forty patients (male 30, female 10) with in-stent restenosis after percutaneous coronary intervention (PCI) were study. They were divided randomly into two groups: single-balloon group (20 cases, control group) and brachytherapy group (20 cases, treatment group). After successful balloon angioplasty satisfactorily treatment of in-stent restenosis, 20 patients were randomly assigned to receive an intravascular brachytherapy ( 90Sr/ 90Y sources). After the operation, there was a 9-month follow-up.Results Within 9-month follow-up, 8 cases (40%) in control group was found to be with in-stent restenosis and two cases (10%) in treatment group. There was significant difference between the two groups (χ 2=4.80, P<0.05). Conclusion The results of this study demonstrated that beta-radiation using 90Sr/ 90Y is safe and effective for preventing recurrence in patients with in-stent restenosis.