Late Intravascular Ultrasound Findings of Patients Treated With Brachytherapy for Diffuse

This study aimed at evaluating long-term (24-month) effects of -irradiation (188Re-MAG3-filled balloon) using intravascular ultrasound (IVUS) in patients with in-stent reste-nosis (ISR). Long-term effects of -irradiation on intimal hyperplasia (IH) within the stented segment and vessel and lumen dimensions of nonstented adjacent segments in patients with ISR have not been sufficiently evaluated. Two-year follow-up IVUS was performed in 30 patients with patent ISR segments at 6-month follow-up angiography. Serial IVUS images were acquired at five equidistant intrastent sites and at three different reference segment sites. IH burden (%) was defined as 100 (IH/stent area). Mean intrastent IH area and IH burden significantly increased between 6 and 24 months, from 2.1 1.1 to 2.6 1.4 mm2 (P < 0.001) and from 26 % 10 % to 33 % 14 % (P < 0.001), respectively. There was a significant decrease of mean external elastic membrane (from 10.1 3.9 to 9.7 3.9 mm2; P 0.015) and lumen area (from 5.6 2.3 to 5.1 2.3 mm2; P 0.021) within distal reference segments between 6 and 24 months. Target lesion revascularization (TLR) was performed in six patients (20%) between 6 and 24 months after -irradiation therapy. There were no significant differences between TLR an