Zapped Arteries Remain Largely Clean And Clear Six Months Postangioplasty, Per BERT-1 Results

November 10, 1997

ORLANDO -- Coronary arteries remain open six months after mild irradiation in 90 percent of postangioplasty patients evaluated in the Beta Radiation for Restenosis Trial (BERT-1), reports Emory University's Spencer B. King III, M.D., principal investigator of BERT-1, today at the 70th American Heart Association Scientific Sessions.

These findings suggest radiation treatment blocks restenosis -- the process by which coronary arteries widened by balloon angioplasty eventually renarrow.

BERT-1 is the first human trial to test the use of low doses of locally-delivered beta radiation for preventing restenosis that occurs in about one-third of patients who undergo angioplasty. A phase III clinical trial based on BERT-1 preliminary data is now evaluating the technique in 1,100 patients at 26 medical centers in North America and Europe.

During the study, specially fitted catheters delivered minute amounts of beta radiation (90Sr/Y) to angioplasty sites in the coronary arteries of 35 patients. The researchers measured the diameter of vessel openings before angioplasty, just after angioplasty and at six months' followup. Subjects' vessels were, on average, 73 percent closed before angioplasty, 25 percent just after angioplasty and 25 percent at the six-month followup.

The increase noted in the diameter of the vessel's opening (lumen) several months after angioplasty when compared to the opening just after angioplasty is referred to as "late loss." The team found that radiation reduced the late loss and late loss index by 85-90 percent.

"Using this system, intracoronary beta radiation was feasible without disrupting the normal cath (cardiac catheterization) lab routine or producing complications," report Dr. King and his colleagues. "As illustrated, the usual late lumen loss was eliminated in most patients."


During angioplasty, a balloon-tipped catheter is threaded through arteries to sites within those arteries that nourish the heart with oxygen-rich blood. As the balloon expands, it pushes plaque against vessel walls and frees up blood flow. Unfortunately, that same lifesaving procedure (as well as the use of tiny metal stents to prop open vessels) triggers an inflammatory response in about one-third of patients, putting them at risk for restenosis and further cardiac complications.

About 500,000 coronary angioplasties are performed domestically each year and another 500,000 are performed annually outside the United States; hence, about 300,000 persons each year are at risk for restenosis after angioplasty. In the United States, repeat angioplasties cost in the billions of dollars.

Dr. King directs the Gruentzig Cardiovascular Disease Research Center and is professor of Medicine (Cardiology) at the Emory University School of Medicine. Other authors of the current study include David O. Williams and Prakash Chougule of Rhode Island Hospital, Raoul Bonan of the Montreal Heart Institute, and Larry Klein, Ron Waxman, Keith A. Robinson, Kris Anderberg, Judy Scruby and Ian R. Crocker, all of the Emory University School of Medicine.

BERT-1 was funded by the National Institutes of Health.
Intracoronary Beta Radiation Inhibits Late Lumen Loss

Following Balloon Angioplasty: Results of the BERT-1 Trial
(Abstract 1211)
Oral presentation: 3:45 p.m., Nov. 10, 1997 (Auditorium)
Spencer B. King III, Emory University;
David O. Williams, Prakash Chougule, Rhode Island Hospital,
Raoul Bonan, Montreal Heart Institute, and
Larry Klein, Ron Waxman, Keith A. Robinson, Kris Anderberg,
Judy Scruby, and Ian R. Crocker, Emory University

Emory University Health Sciences Center

Related Angioplasty Articles from Brightsurf:

Ticagrelor was not superior to clopidogrel to reduce heart attack risk during angioplasty
A new study found the rate of heart attack and severe complications before, during or soon after elective surgery to open a blocked artery was similar between patients treated with clopidogrel and those who received the more potent antiplatelet medication ticagrelor.

Study finds significant variability in doctors' angioplasty death rates
Some doctors have higher or lower than expected death rates from coronary angioplasty procedures, also known as percutaneous coronary intervention (PCI); however, doctors should not be judged solely on the rate of patients who die from the procedure.

Beta-blockers following angioplasty show little benefit for some older patients
Following coronary angioplasty, beta-blockers did not significantly improve mortality rates or reduce the number of future cardiovascular incidents for older patients with stable angina but no history of heart attack or heart failure, according to a study published today in the JACC: Cardiovascular Interventions.

Sleep disorders may predict heart events after angioplasty
People who have had procedures to open blocked heart arteries after acute coronary syndrome (ACS) may have a higher risk of death, heart failure, heart attack and stroke if they have sleep disorders, such as sleep apnea, compared to those who don't.

Reasons for hospital-level variations in bleeding post-angioplasty are unclear
The use of bleeding avoidance strategies has only a modest effect on the variation in bleeding rates post-angioplasty among hospitals performing this procedure, leaving about 70 percent of the causes for this variation unexplained, according to a study published today in JACC: Cardiovascular Interventions.

US prediction models for kidney injury following angioplasty hold up in Japan
Models developed by the American College of Cardiology NCDR CathPCI Registry to predict the likelihood of angioplasty patients developing acute kidney injury and acute kidney injury requiring dialysis have proven to be effective among patients in Japan.

IV beta blockers before angioplasty are safe, but offer no clinical benefit
Giving intravenous beta blockers before performing a coronary angioplasty in patients who had experienced the deadliest form of heart attack -- ST-segment elevation myocardial infarction (STEMI) -- was safe but did not reduce heart attack severity or improve blood flow from the heart's main pumping chamber, according to research presented at the American College of Cardiology's 65th Annual Scientific Session.

Life-threatening bowel ischemia can often be treated by balloon angioplasty
Acute mesenteric ischemia (AMI) can be successfully treated with endovascular therapy such as balloon angioplasty, according to research from the University of Eastern Finland.

Radial access used less than femoral approach for emergency angioplasty
Although using the radial artery as the access point for angioplasty has been linked to reduced bleeding compared to use of the femoral artery, only a small number of high-risk heart attack patients who undergo rescue angioplasty -- emergency procedures following failed therapy with clot-busting drugs -- are treated by radial access, according to a study published today in the Journal of the American College of Cardiology: Cardiovascular Interventions.

Use of rarely appropriate angioplasty procedures declined sharply
The number of angioplasty procedures classified as rarely appropriate declined sharply between 2010 and 2014, as did the number of those performed on patients with non-acute conditions, according to a study published today in the Journal of the American Medical Association and simultaneously presented at a meeting of the American Heart Association in Orlando.

Read More: Angioplasty News and Angioplasty Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to