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Madanat L, Donisan T, Balanescu DV, Jabri A, Al-Abdouh A, Alsabti S, Li S, Kheyrbek M, Mertens A, Hanson I, Dixon S. The contemporary use of intracoronary brachytherapy for instent restenosis: A review. Cardiovasc Revasc Med 2023; 51:67-74. [PMID: 36732133 DOI: 10.1016/j.carrev.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/14/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023]
Abstract
In-stent restenosis (ISR) has been a major limitation in interventional cardiology and constitutes nearly 10 % of all percutaneous coronary interventions in the United States. Drug-eluting stent (DES) restenosis proves particularly difficult to manage and poses a high risk of recurrence and repeat intervention. Intra-coronary brachytherapy (IBT) has been traditionally viewed as a potential treatment modality for ISR. However, its use was hindered by procedural complexity, cost, and the advent of newer-generation DES. Recent data suggests promising results regarding IBT for the treatment of resistant DES-ISR. This review addresses the mechanism of action of IBT, procedural details, and associated risks and complications of its use. It will also highlight the available clinical evidence supporting the use of IBT and the future directions of its utilization in the treatment of ISR.
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Affiliation(s)
- Luai Madanat
- Department of Internal Medicine, Beaumont Hospital, Royal Oak, MI, United States of America.
| | - Teodora Donisan
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine, Rochester, MN, United States of America
| | - Dinu V Balanescu
- Department of Internal Medicine, Beaumont Hospital, Royal Oak, MI, United States of America
| | - Ahmad Jabri
- Department of Cardiovascular Medicine, Heart and Vascular Center, Metrohealth Medical Center, Cleveland, OH, United States of America
| | - Ahmad Al-Abdouh
- Department of Internal Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Sam Alsabti
- Department of Internal Medicine, Beaumont Hospital, Royal Oak, MI, United States of America
| | - Shuo Li
- Department of Internal Medicine, Beaumont Hospital, Royal Oak, MI, United States of America
| | - Mazhed Kheyrbek
- Department of Internal Medicine, Beaumont Hospital, Royal Oak, MI, United States of America
| | - Amy Mertens
- Department of Cardiovascular Medicine, Beaumont Hospital, Royal Oak, MI, United States of America
| | - Ivan Hanson
- Department of Cardiovascular Medicine, Beaumont Hospital, Royal Oak, MI, United States of America
| | - Simon Dixon
- Department of Internal Medicine, University of Kentucky, Lexington, KY, United States of America
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Nakahama H, Jankowski M, Dixon SR, Abbas AE. Long-term outcome of brachytherapy treatment for coronary in-stent restenosis: Ten-year follow-up. Catheter Cardiovasc Interv 2019; 93:E211-E216. [PMID: 30280480 DOI: 10.1002/ccd.27866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/02/2018] [Accepted: 08/12/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The objective of this study was to determine the long-term major adverse cardiac events (MACE) in patients treated with intracoronary brachytherapy (ICBT) for coronary in-stent restenosis (ISR). BACKGROUND ICBT was commonly used to treat coronary ISR prior to the availability of drug-eluting stents (DES). The long-term outcomes of ICBT for ISR remain unknown. METHODS Six hundred and eighty consecutive patients who underwent ICBT treated for ISR between September 1998 and April 2005 were included in the study. Clinical and angiographic data were collected and the long-term MACE were measured for all-cause death, myocardial infarction (MI), and target vessel revascularization (TVR) at 10-year follow-up. RESULTS Patients were 63 ± 11 years old (66% male). The majority of patients were treated with a bare metal stent 670/680 (99%) prior to ICBT. Significant baseline clinical findings include high incidence of smokers 479/680 (70%), hyperlipidemia 638/680 (94%), and multivessel disease 526/680 (77%). The majority of target lesions were diffuse 407/680 (60%), and either in the left anterior descending 258/680 (38%) or right coronary artery 215/680 (32%). At 10-year follow-up, the rate of death was 25%, MI was 22.4%, and TVR was 48%. CONCLUSION MACE at 10-year follow-up following ICBT for ISR indicates steady rate of death and MI and declining rate of TVR after 5 years.
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Affiliation(s)
- Hiroko Nakahama
- Beaumont Hospital Royal Oak, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Michelle Jankowski
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Simon R Dixon
- Beaumont Hospital Royal Oak, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Amr E Abbas
- Beaumont Hospital Royal Oak, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Rochester, Michigan
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Benjo A, Cardoso RN, Collins T, Garcia D, Macedo FY, El-Hayek G, Nadkarni G, Aziz E, Jenkins JS. Vascular brachytherapy versus drug-eluting stents in the treatment of in-stent restenosis: A meta-analysis of long-term outcomes. Catheter Cardiovasc Interv 2016; 87:200-8. [PMID: 25963829 DOI: 10.1002/ccd.25998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 02/12/2015] [Accepted: 04/04/2015] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Clinical trials have shown a short-term benefit of drug-eluting stents (DES) compared to vascular brachytherapy (VBT) for treatment of in-stent restenosis (ISR). The long-term benefits of DES vs. VBT are conflicting in the literature. This study aimed to do a meta-analysis of long-term outcomes of DES compared to VBT for treatment of ISR. METHODS PubMed, EMBASE, Cochrane Central and unpublished data were searched for cohort studies and randomized controlled trials (RCTs) that directly compared VBT to DES for the treatment of ISR. We evaluated the following outcomes at 2-5 years of follow-up: target lesion revascularization (TLR), target vessel revascularization (TVR), myocardial infarction (MI), stent thrombosis, cardiovascular (CV) mortality, and overall mortality. Heterogeneity was defined as I(2) values > 25%. Review Manager 5.1 was used for statistical analysis. RESULTS We included 1,375 patients from five studies, of which three were RCTs. VBT was used to treat ISR in 685 (49.8%) patients. After a 2-5 year follow-up, no significant differences were found between treatment groups regarding MI (P = 0.49), stent thrombosis (P = 0.86), CV mortality (P = 0.35), and overall mortality (P = 0.71). TLR (OR 2.37; CI 1.55-3.63; P < 0.001) and TVR (OR 2.23; CI 1.01-4.94; P = 0.05) were significantly increased in patients who received VBT. CONCLUSION This study suggests that DES are associated with decreased long-term revascularization procedures when compared to VBT for the treatment of ISR. This benefit does not appear to be associated with a significant reduction in mortality or myocardial infarction.
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Affiliation(s)
- Alexandre Benjo
- Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana
| | | | - Tyrone Collins
- Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana
| | - Daniel Garcia
- Department of Medicine, University of Miami, Miami, Florida
| | | | - Georges El-Hayek
- Department of Medicine, St. Luke's Roosevelt Hospital Center, New York, New York
| | - Girish Nadkarni
- Department of Nephrology, Ichan Mount Sinai School of Medicine, New York, New York
| | - Emad Aziz
- Department of Medicine, St. Luke's Roosevelt Hospital Center, New York, New York
| | - J Stephen Jenkins
- Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana
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Sun Y, Li L, Su Q, Lu Y. Comparative Efficacy and Safety of Drug-Eluting Stent and Conventional Therapies in Coronary Heart Disease Patients with In-Stent Restenosis: A Meta-Analysis. Cell Biochem Biophys 2014; 68:211-29. [DOI: 10.1007/s12013-013-9692-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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BERTA BALAZS, RUZSA ZOLTAN, BARCZI GYORGY, BECKER DAVID, GELLER LASZLO, JAMBRIK ZOLTAN, MOLNAR LEVENTE, SZABO GYORGY, MERKELY BELA. Long-Term Clinical Follow-Up after Drug-Eluting Stent Implantation for Bare Metal In-Stent Restenosis. J Interv Cardiol 2013; 26:271-7. [DOI: 10.1111/joic.12027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- BALAZS BERTA
- Semmelweis University, Heart Center; Budapest Hungary
| | - ZOLTAN RUZSA
- Semmelweis University, Heart Center; Budapest Hungary
| | - GYORGY BARCZI
- Semmelweis University, Heart Center; Budapest Hungary
| | - DAVID BECKER
- Semmelweis University, Heart Center; Budapest Hungary
| | - LASZLO GELLER
- Semmelweis University, Heart Center; Budapest Hungary
| | | | | | - GYORGY SZABO
- Semmelweis University, Heart Center; Budapest Hungary
| | - BELA MERKELY
- Semmelweis University, Heart Center; Budapest Hungary
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Lu YG, Chen YM, Li L, Zhao RZ, Fu CH, Yan H. Drug-eluting stents vs. intracoronary brachytherapy for in-stent restenosis: a meta-analysis. Clin Cardiol 2011; 34:344-51. [PMID: 21538389 DOI: 10.1002/clc.20900] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Accepted: 01/24/2011] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND It has been reported that drug-eluting stents (DES) were superior to intracoronary brachytherapy (ICBT) in patients with in-stent restenosis (ISR). However, it is unknown whether there might be differences between DES and ICBT in terms of efficacy and safety in large sample size and long-term follow-up. HYPOTHESIS The aim of this study was to determine whether DES implantation remains favorable in large sample size and long-term follow-up when compared with ICBT among patients with ISR. METHODS We conducted a search in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials without language restrictions. A meta-analysis of 1942 cases from 12 controlled trials of DES vs ICBT for ISR was performed. RESULTS Drug-eluting stents were significantly more effective in reducing target-vessel revascularization (TVR) (odds ratio [OR]: 0.44, 95% confidence interval [CI]: 0.23-0.81, P = 0.009) and binary restenosis (OR: 0.34, 95% CI: 0.26-0.46, P<0.00001) compared with ICBT at midterm follow-up. There were no significant differences between DES and ICBT in cardiac death, myocardial infarction (MI), and late stent thrombosis at midterm follow-up. A statistical significance has been found between the 2 groups in TVR (OR: 0.61, 95% CI: 0.43-0.86, P = 0.005) at long-term follow-up. There were no significant differences in cardiac death and MI between the 2 groups at long-term follow-up. CONCLUSIONS These findings provide evidence that DES is superior to ICBT for the treatment of ISR in TVR and binary restenosis reduction, but not in cardiac death, MI, and late stent thrombosis reduction. © 2011 Wiley Periodicals, Inc. Yong-Guang Lu, MD, and Yan-Mei Chen, MD, contributed equally to this work. The authors have no funding, financial relationships, or conflicts of interest to disclose.
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Affiliation(s)
- Yong-Guang Lu
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Schiele TM, Herbst J, Pöllinger B, Rieber J, König A, Sohn HY, Krötz F, Leibig M, Belka C, Klauss V. Late and very late catch-up after90Sr/90Y beta-irradiation for the treatment of coronary in-stent restenosis. ACTA ACUST UNITED AC 2011; 13:9-13. [DOI: 10.3109/17482941.2010.532221] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hang CL, Hsieh BT, Wu CJ, Yip HK, Yang CH, Chen SM, Hsieh YK, Fu M, Chua S, Guo GBF, Leung SW. Six-Year Clinical Follow-up After Treatment of Diffuse In-Stent Restenosis With Cutting Balloon Angioplasty Followed by Intracoronary Brachytherapy With Liquid Rhenium-188-Filled Balloon via Transradial Approach. Circ J 2011; 75:113-20. [DOI: 10.1253/circj.cj-10-0054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Chi-Ling Hang
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center
- Chang Gung University College of Medicine
| | | | - Chiung-Jen Wu
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center
- Chang Gung University College of Medicine
| | - Hon-Kan Yip
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center
- Chang Gung University College of Medicine
| | - Cheng-Hsu Yang
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center
- Chang Gung University College of Medicine
| | - Shyh-Ming Chen
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center
- Chang Gung University College of Medicine
| | - Yuan-Kai Hsieh
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center
- Chang Gung University College of Medicine
| | - Morgan Fu
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center
- Chang Gung University College of Medicine
| | - Sarah Chua
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center
- Chang Gung University College of Medicine
| | - Gary Bih-Fang Guo
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center
- Chang Gung University College of Medicine
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Wiemer M, König A, Rieber J, Sohn HY, Leibig M, Theisen K, Klauss V, Langer C, Lindner O, Horstkotte D, Schiele T. Sirolimus-eluting stent implantation versus beta-irradiation for the treatment of in-stent restenotic lesions: clinical and ultrasound results from a randomised trial. EUROINTERVENTION 2011; 6:687-94. [DOI: 10.4244/eijv6i6a117] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Beohar N, Meyers SN, Erdogan A, Harinstein ME, Pieper K, Gagnon S, Davidson CJ. Off-label use of drug-eluting versus bare metal stents: a lesion-specific systematic review of long-term outcomes. J Interv Cardiol 2010; 23:528-45. [PMID: 20735712 DOI: 10.1111/j.1540-8183.2010.00588.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The purpose of this systematic review was to evaluate differences in lesion-specific outcomes with the "off-label" use of drug-eluting stents (DES) versus bare metal stents (BMS). METHODS MEDLINE, PubMed, the Cochrane databases, and other Web were searched for studies evaluating off-label use of DES and BMS with the same characteristics. Of 1,258 abstracts or manuscripts reviewed, 112 studies were included (total N = 23,438). Studies were excluded if patients received both types of stent or no stent; lesion type was unknown; lesion-specific outcomes for ≥6 months were unavailable; or <25 patients were enrolled. RESULTS Overall mortality at 6-12 months was approximately 3% for BMS and DES for off-label use. Increase in mortality was greater from 6-12 months to 2 years with BMS than with DES (3.3%-9.1%; 2.8%-4.1%); however, rates were similar at 3 years (BMS: 18.8%; DES:15.3%). Myocardial Infarction rates were similar for both types at 6-12 months (BMS: 6.5%; DES: 6.0%). Overall rates of stent thrombosis were 1.8% and 1.7% for BMS and DES, respectively. Similar or slightly lower rates of stent thrombosis were seen for most lesion types, except higher rates for small vessels for BMS (5.2%) and true bifurcation for DES (3.3%). Rates of target lesion revascularization (TLR) were 7.5% for BMS and 19.6% for DES at 6-12 months. At 2-years TLR remained lower than DES. When the combined group was compared to registry data alone, similar values were seen. CONCLUSIONS Rates of mortality, myocardial infarction (MI), and stent thrombosis were similar in patients receiving BMS or DES, while TLR rates were lower in DES patients.
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Affiliation(s)
- Nirat Beohar
- Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
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Patti G, Di Sciascio G. Antithrombotic strategies in patients on oral anticoagulant therapy undergoing percutaneous coronary intervention: a proposed algorithm based on individual risk stratification. Catheter Cardiovasc Interv 2010; 75:128-34. [PMID: 19670304 DOI: 10.1002/ccd.22200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
An increasing number of patients on chronic oral anticoagulant therapy undergo percutaneous coronary intervention. There is a lack of evidence-based data and no practice guidelines are available about the optimal antithrombotic treatment of such patients after the procedure; thus, the adopted strategies are highly variable and are often left to the discretion of the attending physician. In this article, we review current evidence and propose an algorithm of antithrombotic strategies tailored to the individual patient, which takes into account the relative risks of bleeding, ischemic complications, and thromboembolism.
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Affiliation(s)
- Giuseppe Patti
- Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, Rome, Italy
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Holmes DR Jr, Teirstein PS, Satler L, Sketch MH Jr, Popma JJ, Mauri L, Wang HP, Schleckser PA, Cohen SA; SISR Investigators. 3-year follow-up of the SISR (Sirolimus-Eluting Stents Versus Vascular Brachytherapy for In-Stent Restenosis) trial. JACC Cardiovasc Interv 2008; 1:439-48. [PMID: 19463342 DOI: 10.1016/j.jcin.2008.05.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Revised: 05/16/2008] [Accepted: 05/29/2008] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate long-term outcome of patients treated for in-stent restenosis of bare-metal stents (BMS). BACKGROUND Treatment of restenosis of BMS is characterized by high recurrence rates. Vascular brachytherapy (VBT) improved outcome although late catch-up events were documented. Drug-eluting stents tested against VBT in this setting were found superior for at least the first year; superiority at longer follow-up is uncertain. METHODS We evaluated 3-year outcome of the multicenter SISR (Sirolimus-Eluting Stents Versus Vascular Brachytherapy for In-Stent Restenosis) trial, which randomized patients with restenosis of BMS to either a sirolimus-eluting stents (SES) or VBT. RESULTS Target vessel failure (cardiac death, infarction, or target vessel revascularization [TVR]) at 9 months as previously reported was significantly improved with SES. Kaplan-Meier analysis at 3 years documented that survival free from target lesion revascularization (TLR) and TVR continues to be significantly improved with SES: freedom from TLR 81.0% versus 71.6% (log-rank p = 0.018), and TVR 78.2% versus 68.8% (log-rank p = 0.022), SES versus VBT. At 3 years, target vessel failure and major adverse cardiac events (death, infarction, emergency coronary artery bypass grafting, or repeat TLR) remained improved with SES, but did not reach statistical significance. There was no statistically significant difference in definite or probable stent thrombosis (3.5% for SES, 2.4% for VBT; p = 0.758). CONCLUSIONS At 3 years of follow-up, after treatment of in-stent restenosis of BMS, patients treated with SES have improved survival free of TLR and TVR compared with patients treated with VBT. Stent thrombosis rates are not different between the 2 groups but are higher than reported in trials of treatment of de novo lesions.
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Alfonso F, Pérez-Vizcayno MJ, Hernández R, Bethencourt A, Martí V, López-Mínguez JR, Angel J, Iñiguez A, Morís C, Cequier A, Sabaté M, Escaned J, Jiménez-Quevedo P, Bañuelos C, Suárez A, Macaya C. Long-term clinical benefit of sirolimus-eluting stents in patients with in-stent restenosis results of the RIBS-II (Restenosis Intra-stent: Balloon angioplasty vs. elective sirolimus-eluting Stenting) study. J Am Coll Cardiol 2008; 52:1621-7. [PMID: 18992651 DOI: 10.1016/j.jacc.2008.08.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 08/11/2008] [Accepted: 08/19/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We sought to assess the long-term effectiveness and safety of sirolimus-eluting stents (SES) in patients with in-stent restenosis (ISR). BACKGROUND Treatment of patients with ISR remains a challenge. The long-term outcome of patients with ISR treated with SES remains unknown. METHODS The RIBS-II (Restenosis Intra-stent: Balloon angioplasty vs. elective sirolimus-eluting Stenting) study was a randomized trial conducted in 150 patients with ISR (76 SES, 74 balloon angioplasty [BA]). The long-term (>1 year) clinical outcome and pre-specified subgroup analyses were pre-defined secondary study end points. RESULTS At 1 year, the event-free survival (death, myocardial infarction, target vessel revascularization [TVR]) was better in the SES group (88% vs. 69%, p < 0.005). Additional long-term (>3 years) clinical follow-up was obtained in 97% of patients (median 3.3 years). After the first year, 3 patients died (1 SES, 2 BA), 5 suffered myocardial infarction (4 SES, 1 BA), and 7 required TVR (4 SES, 3 BA). At last follow-up, definitive/probable/possible stent thrombosis was similar in both groups (2/2/1 SES vs. 1/0/3 BA, p = NS). At 4 years, the event-free survival was 76% in the SES arm and 65% in the BA arm (p = 0.019). On multivariate analysis, SES implantation was an independent predictor of event-free survival. Subgroup analyses were consistent with the main outcome measure. CONCLUSIONS In patients with ISR, SES implantation remains effective and safe at very long-term clinical follow-up.
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BONELLO LAURENT, KANESHIGE KIMBERLY, DE LABRIOLLE AXEL, ROY PROBAL, LEMESLE GILLES, TORGUSON REBECCA, SATLER LOWELLF, PICHARD AUGUSTOD, LINDSAY JOSEPH, WAKSMAN RON. Vascular Brachytherapy for Patients with Drug-Eluting Stent Restenosis. J Interv Cardiol 2008; 21:528-34. [DOI: 10.1111/j.1540-8183.2008.00414.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Sheiban I, Chiribiri A, Galli S, Biondi-Zoccai G, Montorsi P, Beninati S, Fabbiocchi F, Moretti C, Omedè P, Trabattoni D, Lotrionte M, Trevi GP, Bartorelli AL. Sirolimus-eluting stent implantation for bare-metal in-stent restenosis: is there any evidence for a late catch-up phenomenon? J Cardiovasc Med (Hagerstown) 2008; 9:783-8. [PMID: 18607241 DOI: 10.2459/jcm.0b013e3282fb7882] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Dixon SR, Grines CL, O'Neill WW. The year in interventional cardiology. J Am Coll Cardiol 2008; 51:2355-69. [PMID: 18549922 DOI: 10.1016/j.jacc.2008.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 03/17/2008] [Accepted: 03/18/2008] [Indexed: 11/22/2022]
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