TY - JOUR
T1 - Coronary Intravascular Brachytherapy for Recurrent Coronary Drug-Eluting Stent In-Stent Restenosis
T2 - A Systematic Review and Meta-Analysis
AU - Megaly, Michael
AU - Glogoza, Matthew
AU - Xenogiannis, Iosif
AU - Vemmou, Evangelia
AU - Nikolakopoulos, Ilias
AU - Omer, Mohamed
AU - Saad, Marwan
AU - Willson, Laura
AU - Monyak, David J.
AU - Sullivan, Patsa
AU - Pershad, Ashish
AU - Chavez, Ivan
AU - Mooney, Michael
AU - Traverse, Jay
AU - Wang, Yale
AU - Garcia, Santiago
AU - Poulose, Anil
AU - Burke, M. Nicholas
AU - Brilakis, Emmanouil S.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/2
Y1 - 2021/2
N2 - Objective: To examine the outcomes with intravascular brachytherapy (IVBT) in recurrent in-stent restenosis (ISR). Background: Recurrent ISR can be challenging to treat and IVBT can be used for recurrent ISR but has received limited study. Methods: We performed a systematic review and meta-analysis of five observational studies, including 917 patients (1014 lesions) with recurrent ISR, defined as having at least two prior ISR episodes with previous treatment with a stent, who underwent treatment with IVBT. Outcomes of interest included target vessel revascularization (TVR), myocardial infarction (MI), and all-cause mortality. Results: During a mean follow-up of 24 ± 7 months, the incidence of TVR was 29.2% (95% CI 18.0–40.4%). The incidence of MI and all-cause mortality were 4.3% (95% CI 1.7%–6.9%) and 7.3% (95% CI 3.2–11.5%), respectively. At one- and two-years after PCI the incidence of TVR was 17.5% (95% CI 13.6%–21.4%) and 26.7% (95% CI 16.6%–36.9%), respectively and the incidence of MI was 3.1% (95% CI 2–4.2%) and 3.9% (95% CI 1–6.8%), respectively. Conclusion: Intravascular brachytherapy can be used to treat recurrent ISR, although TVR is needed in approximately one of four patients at two years.
AB - Objective: To examine the outcomes with intravascular brachytherapy (IVBT) in recurrent in-stent restenosis (ISR). Background: Recurrent ISR can be challenging to treat and IVBT can be used for recurrent ISR but has received limited study. Methods: We performed a systematic review and meta-analysis of five observational studies, including 917 patients (1014 lesions) with recurrent ISR, defined as having at least two prior ISR episodes with previous treatment with a stent, who underwent treatment with IVBT. Outcomes of interest included target vessel revascularization (TVR), myocardial infarction (MI), and all-cause mortality. Results: During a mean follow-up of 24 ± 7 months, the incidence of TVR was 29.2% (95% CI 18.0–40.4%). The incidence of MI and all-cause mortality were 4.3% (95% CI 1.7%–6.9%) and 7.3% (95% CI 3.2–11.5%), respectively. At one- and two-years after PCI the incidence of TVR was 17.5% (95% CI 13.6%–21.4%) and 26.7% (95% CI 16.6%–36.9%), respectively and the incidence of MI was 3.1% (95% CI 2–4.2%) and 3.9% (95% CI 1–6.8%), respectively. Conclusion: Intravascular brachytherapy can be used to treat recurrent ISR, although TVR is needed in approximately one of four patients at two years.
KW - DES ISR
KW - IVBT
KW - In-stent restenosis
KW - Intravascular brachytherapy
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U2 - 10.1016/j.carrev.2020.08.035
DO - 10.1016/j.carrev.2020.08.035
M3 - Article
C2 - 32883584
AN - SCOPUS:85090067437
SN - 1553-8389
VL - 23
SP - 28
EP - 35
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
ER -