To examine the outcomes with intravascular brachytherapy (IVBT) in recurrent in-stent restenosis (ISR).
Recurrent ISR can be challenging to treat and IVBT can be used for recurrent ISR but has received limited study.
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.
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.
Intravascular brachytherapy can be used to treat recurrent ISR, although TVR is needed in approximately one of four patients at two years.
Cardiovascular Revascularization Medicine Volume 23, February 2021, Pages 28-35
Read the full article on Science Direct: Coronary Intravascular Brachytherapy for Recurrent Coronary Drug-Eluting Stent In-Stent Restenosis: A Systematic Review and Meta-Analysis