B-28 | Management of Clinical Stent-In-Stent Restenosis (SISR) in High Risk Coronary Artery Disease Patients With Percutaneous Coronary Intervention (PCI) Followed by Coronary Intravascular Brachytherapy (IVBT)
نویسندگان
چکیده
In-stent-restenosis (ISR) is seen in 10% of patients with DES and often treated a repeat placement. Recurrent ISR or SISR has high failure rates, requiring target vessel revascularization (TVR). A combination the presence multiple layers stents, previous restenosis, other additional comorbidities make this patient population complex higher risk. Angioplasty followed by IVBT one possible treatment option high-risk patients. This study reviewed efficacy safety PCI for coronary artery disease experiencing SISR. retrospective was performed which 78 between 2016-2021 involving total 91 vessels. All underwent balloon angioplasty IVBT. These received localized radiation using Novoste Beta-Cath System strontium-90 isotope. Radiation dose delivered based on diameter, vessels ≥ 3.5mm diameter receiving 23 Gy, while <3.5mm 18.4 Gy. Major adverse cardiac events (MACE) were defined as all-cause death, myocardial infarction (MI), stroke. cohort had 2 previously placed DESs lesion. Of treatments, 67% 33% treatments to LAD RCA circumflex marginal arteries, respectively. One intraprocedural arrest due suspected intracoronary thrombosis. symptomatic pre-IVBT 44% experienced reduction after treatment. MACE includes MI 18%, stroke 5%, death occurred 16% at median time 9.3 months post follow-up being 22.8 months. total, 77% retained patency irradiated lesion, 23% percent restenosis TVR. Coronary post-deployment remains an ongoing challenge current times. safe efficacious SISR, who have very few options otherwise.
منابع مشابه
Association of G22A variant of Adenosine Deaminase gene with coronary in-stent restenosis in coronary artery patients receiving drug-eluting stent
In-stent restenosis (ISR) is regarded as the main problem in the utilization of stents in the treatment of coronary artery atherosclerotic stenosis in percutaneous coronary intervention (PCI). This study investigated the possible role of the G22A variant of the Adenosine Deaminase gene (ADA) in the development of ISR. In this study, 91 patients who underwent PCI were divided into two groups of ...
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ژورنال
عنوان ژورنال: Journal of the Society for Cardiovascular Angiography & Interventions
سال: 2023
ISSN: ['2772-9303']
DOI: https://doi.org/10.1016/j.jscai.2023.100748