The birth, decline, and contemporary re-emergence of endovascular brachytherapy for prevention of in-stent restenosis
| Autor: | Colin M. Barker, Alexander D. Sherry, Mohamed H. Khattab |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Brachytherapy Interventional management Constriction Pathologic 030218 nuclear medicine & medical imaging Coronary artery disease Coronary Restenosis 03 medical and health sciences 0302 clinical medicine Restenosis Medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Angioplasty Balloon Coronary business.industry General surgery Treatment options medicine.disease Endovascular brachytherapy Stent placement surgical procedures operative Treatment Outcome Oncology Intravascular brachytherapy 030220 oncology & carcinogenesis cardiovascular system Stents In stent restenosis business |
| Zdroj: | Brachytherapy. 20(2) |
| ISSN: | 1873-1449 |
| Popis: | Despite the advent of drug-eluting stents and dual antiplatelet therapy in the interventional management of cardiovascular disease, restenosis rates remain high with significant sequelae. Endovascular brachytherapy-popular in the 1990s and early 2000s-has recently resurfaced as a cost-effective treatment option. In this work, we outline the history of endovascular brachytherapy starting with its earliest promise in the 1990s. We discuss the development of drug-eluting stents and dual antiplatelet strategies and their impact on the perceived benefit of endovascular brachytherapy. For the contemporary era, we propose novel roles for endovascular brachytherapy in complex coronary artery disease and in high-risk patients managed with drug-eluting stents. We discuss the impetus for reducing the requirement and duration of dual antiplatelet therapy using endovascular brachytherapy. We also review innovative opportunities for endovascular brachytherapy after bare-metal stent placement in both coronary and noncoronary territories and offer economic arguments in favor of endovascular brachytherapy. Trials of endovascular brachytherapy in these regimes are merited. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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