Usefulness of Intracoronary Brachytherapy for Patients With Resistant Drug-Eluting Stent Restenosis

Mangione, Fernanda Marinho; Jatene, Tannas; Eslam, Roza Badr; Bergmark, Brian A; Gallagher, Jacob R.; Shah, Pinak; Mauri, Laura; Leopold, Jane A.; Sobieszczyk, Piotr; Faxon, David P.; Croce, Kevin; Bhatt, Deepak L.; Devlin, Phillip M.

doi:10.1016/j.amjcard.2017.04.036

Cited by 22 publications

(22 citation statements)

References 17 publications

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“…Varghese et al demonstrated that using VBT in recurrent DES‐ISR was associated with lower major adverse cardiac events compared with other therapies at 1 year 10 . Despite the classic description of focal restenosis with DES‐ISR, a higher percentage of recurrent DES‐ISR lesions had diffuse ISR as described in our cohort and by Mangione et al 8 …”

Section: Discussioncontrasting

confidence: 40%

“…Of multiple treatment options, such as balloon angioplasty (BA), 6 drug‐coated balloons (DCB), 7 or repeat DES implantation, vascular brachytherapy (VBT) can inhibit neointimal growth without antiproliferative drugs or additional metal layers. There are limited data, however, on the use of brachytherapy for recurrent DES‐ISR 8–10 . We report a large, single‐center experience on long‐term outcomes after VBT for recurrent DES‐ISR.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of intravascular brachytherapy for recurrent drug‐eluting in‐stent restenosis

Megaly

Glogoza

Xenogiannis

et al. 2020

Cathet Cardio Intervent

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Objectives: To examine the outcomes of vascular brachytherapy (VBT) for recurrent drug-eluting stents (DES) in-stent restenosis (ISR). Background: Recurrent DES-ISR can be challenging to treat. VBT has been used with encouraging results. Methods: We report the long-term outcomes of patients with recurrent DES-ISR treated with VBT between January 2014 and September 2018 at a tertiary care institution. The main outcome was target lesion failure (TLF), defined as the composite of clinically driven target lesion revascularization (TLR), target lesion myocardial infarction (MI), and target lesion-related cardiac death. Cox proportional hazards analysis was performed to identify variables associated with recurrent TLF. Results: During the study period, 116 patients (143 lesions) underwent VBT. Median follow-up was 24.7 (14.5-35.4) months. The incidence of TLR, target-lesion MI, and

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Section: Discussioncontrasting

confidence: 40%

Section: Introductionmentioning

confidence: 99%

Outcomes of intravascular brachytherapy for recurrent drug‐eluting in‐stent restenosis

Megaly

Glogoza

Xenogiannis

et al. 2020

Cathet Cardio Intervent

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“…123,124 Unfortunately, there are scant data for treating ISR lesions involving multiple previously placed stent layers. 125…”

Section: In-stent Restenosismentioning

confidence: 99%

SCAI position statement on optimal percutaneous coronary interventional therapy for complex coronary artery disease

Riley

Henry

Mahmud

et al. 2020

Cathet Cardio Intervent

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“…The American Heart Association/American College of Cardiology guidelines provides a class IIa recommendations for DES use for the treatment of bare metal stent (BMS) ISR and a class IIb recommendation for treatment of DES ISR with DES/BMS/angioplasty 13 . More recently, some initial reports have reported encouraging results with the use of ICBT for DES ISR 14–16 …”

Section: Introductionmentioning

confidence: 99%

Northwell intracoronary brachytherapy for the treatment of recurrent drug eluting stent in‐stent restenosis (NITDI study group)

Meraj

Patel

et al. 2020

Cathet Cardio Intervent

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Objective: The purpose of this study is to report on safety, short-term and long-term clinical efficacy following intracoronary brachytherapy (ICBT) for restenosis (ISR) in patients with drug eluting stents (DES). Background: ICBT is an effective treatment for ISR of bare metal stents (BMS) but its utilization has waned due to the advent of DES. ISR following DES occurs at a frequency of 8% or greater. Method: A retrospective analysis was performed on patients treated on an institutional review board (IRB) approved protocol using ICBT for DES ISR between January 2011 and October 2016. All patients were followed for 24 months for procedural complications, mortality, clinical ISR/target lesion revascularization (TLR) and stroke. Results: A total of 290 patients were identified with a mean age of 66.6 years. All of them had high rates of typical coronary artery disease risk factors. Our primary outcome, composite of in-hospital mortality, myocardial infarction (MI), safety outcomes and procedural failure was noted in 1(0.3%) patient who had a MI. No other secondary outcome was noted in-hospital. At 1-year follow up, 12.4% patients had ISR, 1.7% patients died, and 1 (0.3%) had ischemic stroke. At 2-year, 14.7% had ISR, and total 6 (2.1%) patients had MI. Conclusion: ICBT demonstrates excellent technical success rates for treatment, safety, and reasonable efficacy over 2-years to be free from recurrent clinical ISR. This study represents the largest ICBT data for DES ISR to date among very complex lesion subsets, however, more prospective data will be needed to determine the optimal patient for treatment.

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Usefulness of Intracoronary Brachytherapy for Patients With Resistant Drug-Eluting Stent Restenosis

Cited by 22 publications

References 17 publications

Outcomes of intravascular brachytherapy for recurrent drug‐eluting in‐stent restenosis

Outcomes of intravascular brachytherapy for recurrent drug‐eluting in‐stent restenosis

SCAI position statement on optimal percutaneous coronary interventional therapy for complex coronary artery disease

Northwell intracoronary brachytherapy for the treatment of recurrent drug eluting stent in‐stent restenosis (NITDI study group)

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