Late coronary occlusion after intracoronary brachytherapy
Late coronary occlusion after intracoronary brachytherapy
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DOI：
10.1161/01.cir.100.8.789
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发表时间：
1999-08-24
期刊：
影响因子：
37.8
通讯作者：
Serruys, PW
中科院分区：
文献类型：
--
作者：
Costa, MA;Sabaté, M;Serruys, PW
背景：冠状动脉内近距离放射治疗似乎是一种很有前途的预防再狭窄的技术，目前，关于这种治疗方式的晚期安全性的数据有限。该研究的目的是确定PTCA和放疗后晚期（bb10 - 1个月）血栓的发生率。方法与结果：1997年4月~ 1999年3月，对108例PTCA患者行冠状动脉内放射治疗。91例患者完成了至少2个月的临床随访。在这些患者中，6.6%（6例）在干预后2至15个月（2例球囊血管成形术和4例支架）出现血管造影证实的突发性血栓事件。一些因素（重叠的支架，未愈合的夹层）可能引发血栓形成过程，但事件发生的时间非常不寻常。因此，辐射对延迟愈合过程和维持血栓形成的冠状动脉表面的影响被认为是解释这些晚期事件的最合理的机制。结论：PTCA术后冠状动脉内放疗后迟发性突发性血栓形成是介入心脏病学的新现象。
Background-Intracoronary brachytherapy appears to be a promising technology to prevent restenosis, Presently, limited data are available regarding the late safety of this therapeutic modality. The aim of the study was to determine the incidence of late (>1 month) thrombosis after PTCA and radiotherapy.Methods and Results-From April 1997 to March 1999, we successfully treated 108 patients with PTCA followed by intracoronary beta-radiation. Ninety-one patients have completed at least 2 months of clinical follow-up. Of these patients, 6.6% (6 patients) presented with sudden thrombotic events confirmed by angiography 2 to 15 months after intervention (2 balloon angioplasty and 4 stent). Some factors (overlapping stents, unhealed dissection) may have triggered the thrombosis process, but the timing of the event is extremely unusual. Therefore, the effect of radiation on delaying the healing process and maintaining a thrombogenic coronary surface is proposed as the most plausible mechanism to explain such late events.Conclusions-Late and sudden thrombosis after PTCA followed by intracoronary radiotherapy is a new phenomenon in interventional cardiology.