Intracoronary brachytherapy, a safe, feasible option for drug-eluting stent restenosis
USA: Intracoronary brachytherapy (ICBT) for patients with in-stent restenosis (ISR) of a drug-eluting stent (DES) is a safe and effective treatment option. However, with the number of stent layers, there is a decrease in its effectiveness, says a recent study. The findings were published in the Journal of the Society for Cardiovascular Angiography & Interventions on 2 January 2023.
Many existing studies of intracoronary brachytherapy include mostly bare metal stent (BMS) in-stent restenosis or single drug-eluting stent ISR, or they need to report the number of stent layers. Data is required for this population because DES is now the predominant strategy for treating stable and unstable coronary lesions. Considering this, Stephen Ellis from Heart, Vascular, and Thoracic Institute in Cleveland Clinic, Cleveland, Ohio, and colleagues aimed to report outcomes of intracoronary brachytherapy in treating drug-eluting stent in-stent restenosis and identify correlated factors.
For this purpose, the researchers included patients who underwent ICBT for DES ISR from 2010 to 2021 in the single-institution retrospective PCI registry. Patients were treated with laser atherectomy, balloon angioplasty, and rotational atherectomy followed by ICBT at a dose of 18.4-25 Gy delivered at the ISR site with a dose estimated by the reference vessel size.
A 3-year target lesion failure rate was determined (primary outcomes). Secondary endpoints included 1-year r target lesion failure rate (TLF), all-cause mortality, target lesion revascularization (TLR), and cardiac mortality.
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