Key result
Combined cutting balloon angioplasty and intracoronary beta radiation for in-stent restenosis was associated with lower rates of target vessel revascularization (7% vs. 18%, P<0.05) compared to other PCI techniques.
Why the study?
Does combined cutting balloon angioplasty and intracoronary beta radiation reduce TVR and MACE in patients with in-stent restenosis compared to other PCI techniques without radiation?
Cohort (n=495)
Does combined cutting balloon angioplasty and intracoronary beta radiation reduce TVR and MACE in patients with in-stent restenosis compared to other PCI techniques without radiation?
Combined cutting balloon angioplasty and intracoronary beta radiation is associated with lower rates of target vessel revascularization and MACE compared to other PCI techniques without radiation for the treatment of in-stent restenosis.
Answers are grounded in this paper and cite their sources.
May support combined cutting balloon and beta radiation in restenosis; leaves open randomized confirmation before practice change.
Intracoronary beta (beta) radiation decreases the incidence of target lesion revascularization after percutaneous intervention (PCI) for in-stent restenosis (ISR). Cutting balloon (CB) angioplasty may also be superior to other percutaneous techniques for the treatment of ISR. We sought to study the outcomes of patients with ISR who underwent both CB angioplasty and intracoronay beta radiation and compare them to patients with ISR who underwent other PCI techniques without concomitant radiation. We also sought to evaluate the safety and efficacy of pullback intracoronary beta radiation for the treatment of long ISR lesions. Between January 2001 and November 2001, 102 patients (mean age = 55 +/- 13 years) with ISR underwent both CB angioplasty and intracoronay beta radiation. beta radiation was delivered using the Beta Cath (Novoste) 30 mm system, and pullback radiation was performed in 41 patients. A comparison group included a total of 393 patients with ISR who underwent other PCI techniques without concomitant intracoronary radiation therapy. Follow-up was obtained in 99 patients (97%) in the CB angioplasty with intracoronary radiation group and 377 patients (96%) in the comparison group. At follow-up, both target vessel revascularization (TVR) and major adverse cardiovascular events (MACE) occurred significantly less in the CB angioplasty with intracoronary radiation group than in the comparison group (7% vs. 18% for TVR, and 14% vs. 24% for MACE; P < 0.05 for both). In the pullback radiation group, TVR was performed in five patients (12%), and MACE occurred in eight patients (20%). A combination of CB angioplasty and intracoronay beta radiation for ISR seems to yield low rates of subsequent target vessel revascularization and adverse cardiac events. In addition, pullback beta radiation using the Beta Cath (Novoste) 30 mm system is safe and can be used to treat long ISR lesions effectively. Further randomized trials are needed to confirm these findings.
No takes yet. Share an insight, caveat, or question.
Moustapha et al. (2002) conducted a cohort in in-stent restenosis (ISR) (n=495). Combined cutting balloon angioplasty and intracoronary beta radiation vs. Other PCI techniques without concomitant intracoronary radiation therapy was evaluated on target vessel revascularization (TVR) (p=<0.05). Combined cutting balloon angioplasty and intracoronary beta radiation for in-stent restenosis was associated with lower rates of target vessel revascularization (7% vs. 18%, P<0.05) compared to other PCI techniques.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: