American College of Cardiology

ACC 49th Annual Scientific Session
Late-Breaking Clinical Trials
in Interventional Cardiology (#72)
Monday, March 13, 2000 (9:15 a.m.-10:45 a.m.)

(ANAHEIM, CALIF.)—Arterial renarrowing within six months after insertion of a coronary stent has become a major limitation of this increasingly common form of therapy for diseased heart vessels. Renarrowing within stents, or in-stent restenosis, that occupies a long segment of artery is more likely to close off entirely than a short in-stent restenosis lesion. Such long, in-stent lesions do not respond well to standard treatment, which is usually balloon angioplasty. But a study is exploring whether balloon angioplasty followed by a form of radiotherapy, called intracoronary brachytherapy, can successfully treat such long, high-risk lesions.

At the American College of Cardiology 49th Annual Scientific Session in Anaheim, Calif., Dr. Ron Waksman, of the Washington Hospital Center in Washington, D.C., will present six-month follow-up data from a study called LONG WRIST (Washington Radiation for In-Stent Restenosis Trial for Long Lesions).

“This study is evaluating the efficacy of gamma radiation for the treatment of long, in-stent restenosis lesions, those from 4 cm to 8 cm in length,” said Dr. Waksman. He is scheduled to make his presentation on Monday, March 13, at 10:00 a.m.

In LONG WRIST, in-stent restenosis lesions in 120 patients were treated with balloon angioplasty, after which metal inserts that emit gamma radiation (or placebo inserts) were temporarily placed within them. The radioactive inserts consist of a small ribbon studded with “seeds” or pellets made of the gamma emitter iridium-192. The placebo inserts were made of a nonradioactive material.

“We know that gamma radiation can prevent in-stent restenosis. The question is, will it be effective for these long lesions?” said Dr. Waksman.