Comparison Between Sirolimus-Eluting Stents and Intracoronary Catheter-Based Beta Radiation for the Treatment of In-Stent Restenosis

Treatment of diffuse IN-stent restenosis with Drug-Eluting stents vs. intracoronary bEta-raDiation therapy: INDEED Study

“…Moreover, several studies showed encouraging results regarding SES implantation for ISR. Three non-randomized studies comparing SES and brachytherapy demonstrated that SES was superior or equivalent to brachytherapy [11,12,23]. Recent randomized trials showed that SES (SISR trial) or paclitaxel-eluting stent (TAXUS V ISR trial) implantation resulted in superior clinical and angiographic outcomes compared to vascular brachytherapy [13,24].…”

“…The effectiveness of sirolimuseluting stents (SES) on inhibition of neointimal hyperplasia in de novo native artery lesions has been proven in several randomized trials [7,8], and recent results of SES implantation in patients with bare metal ISR appear to be promising [9,10]. Nonrandomized studies comparing SES and ICBT for ISR found that SES implantation showed that SES implantation was equivalent or superior to ICBT in terms of clinical outcomes [11,12] while recent randomized trial showed that SES implantation was superior to vascular brachytherapy in terms of clinical and angiographic outcomes [13].…”

Late Restenosis Following Placement of a Sirolimus Eluting Stent for In-Stent Restenosis

“…4 A prospective study comparing intracoronary brachytherapy and SES for ISR with 12-month angiographic follow up showed the superiority of SES. 5 Longer-term follow-up data however are as yet unavailable.…”

Beta-radiation reduces the reactivity of extra cellular matrix proteins in intravascular brachytherapy (IVBT), resulting in decreased platelet adhesion

“…It has been shown to be favorable in comparison to placebo. IVBT has been recognized as a treatment modality for reducing coronary restenosis after angioplasty and stentimplantation procedures [7][8][9][10]. Single doses in excess of 7-56 Gy intracoronary catheter-based beta-radiations have clearly shown a reduction the genesis of restenosis in the animal and clinical models [11,12].…”