Coronary Intravascular Brachytherapy for Recurrent Coronary Drug-Eluting Stent In-Stent Restenosis: A Systematic Review and Meta-Analysis
| Autor: | Ashish Pershad, Yale Wang, Patsa Sullivan, Michael Megaly, Ilias Nikolakopoulos, Mohamed Omer, Iosif Xenogiannis, Ivan Chavez, Laura Willson, Santiago Garcia, Evangelia Vemmou, Michael Mooney, David J. Monyak, Matthew Glogoza, M. Nicholas Burke, Emmanouil S. Brilakis, Anil Poulose, Jay H. Traverse, Marwan Saad |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Brachytherapy 030204 cardiovascular system & hematology Coronary Angiography Coronary Restenosis 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Restenosis medicine Humans 030212 general & internal medicine Myocardial infarction business.industry Incidence (epidemiology) Stent Drug-Eluting Stents General Medicine medicine.disease Treatment Outcome Intravascular brachytherapy Drug-eluting stent Meta-analysis Conventional PCI Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular revascularization medicine : including molecular interventions. 23 |
| ISSN: | 1878-0938 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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