Washington Radiation for In-Stent restenosis Trial - BETA WRIST


Use of beta-radiation to prevent recurrent in-stent restenosis after angioplasty.


Intracoronary gamma-radiation therapy reduces recurrent in-stent restenosis (ISR). This study was designed to examine the efficacy and safety of the beta-emitter 90-yttrium for the prevention of recurrent ISR.

Study Design

Study Design:

Patients Screened: 50
Patients Enrolled: 50
Mean Follow Up: 6 months
Mean Patient Age: 60 +/- 10 years
Female: 40

Patient Populations:

Diameter stenosis >50% Vessels 2.5 to 4.0 mm in diameter Lesion length <47 mm Successful primary treatment (<30% residual stenosis without complications) .


Recent (<72 hours) acute myocardial infarction (MI) Ejection fraction <20% Angiographic thrombus Multiple lesions in the same vessel.

Primary Endpoints:

Cumulative composite clinical outcome (major adverse clinical events [MACE]) of death, MI, and repeat target lesion revascularization at 6 months.

Secondary Endpoints:

Restenosis Late loss (in millimeters Loss index (late loss/acute gain).

Drug/Procedures Used:

Beta-radiation using a Yttrium-90 source wire through a centering catheter with a prescribed dose of 20.6 Gray at 1.0 mm.

Principal Findings:

At 6 months, the binary angiographic restenosis rate was 22%, the target lesion revascularization rate was 26%, and the target vessel revascularization rate was 34%; all rates were significantly lower than those of the placebo group of [gamma]-WRIST.


Beta radiation with a 90-yttrium source used as adjunct therapy for patients with in stent restenosis results in a lower-than-expected rate of angiographic and clinical restenosis.


Circulation (Online). 101(16):1895-8, 2000 Apr 25

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Stable Ischemic Heart Disease, Chronic Angina

Keywords: Beta Particles, Coronary Restenosis, Constriction, Pathologic, Angioplasty, Stents

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