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Intravascular radiotherapy prevents arterial restenosis

An international trial has shown that intravascular radiotherapy can prevent artery re-narrowing after stent implantation.

By | September 20, 2000

LONDON, September 20 (SPIS MedWire). Low-dose internal radiotherapy is effective in preventing coronary artery narrowing after stent implantation, an international trial has shown.

Speaking at the European Society for Therapeutic Radiology and Oncology conference in Istanbul this week, Dr Ian Crocker from the Department of Radiation Oncology at Emory University School of Medicine, USA, presented results from the START (STents And Radiation Therapy Trial) trial, conducted in 50 North American and European centres.

"This is the first clinical trial to evaluate the safety and effectiveness of beta, rather than gamma, radiation for patients with in-stent restenosis," he said. Immediately following the procedure to open their blocked stents, 476 patients were randomized to receive either a beta radiation source (Strontium 90) for 3-5 minutes or placebo (no treatment). Eight months later, all patients returned for an angiogram.

Dr Crocker said that patients treated with beta radiation had a significant reduction in major adverse cardiac events, as well as a 34% reduction in the number of repeat procedures. Within the stent itself, a 66% reduction in restenosis was observed. In recent clinical trials of vascular brachytherapy, there has been some concern about late thrombus formation in patients receiving new stents in conjunction with radiation. But of the 21% of patients in the START study who were implanted with new stents, no cases of clinical stent thrombosis were reported.

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