TY  - BOOK
AU  - Chan, Rosanna
AU  - Gai, Jiaxiang
AU  - Kiramijyan, Starkis
AU  - Koifman, Edward
AU  - Negi, Smita I
AU  - Pichard, Augusto D
AU  - Randolph, Pamela
AU  - Satler, Lowell F
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Intracoronary Brachytherapy for Recurrent Drug-Eluting Stent Failure
SN  - 1936-8798
PY  - 2016///
KW  - *Brachytherapy
KW  - *Coronary Restenosis/th [Therapy]
KW  - *Coronary Vessels/re [Radiation Effects]
KW  - *Drug-Eluting Stents
KW  - *Percutaneous Coronary Intervention/is [Instrumentation]
KW  - *Prosthesis Failure
KW  - Aged
KW  - Brachytherapy/ae [Adverse Effects]
KW  - Coronary Restenosis/dg [Diagnostic Imaging]
KW  - Coronary Restenosis/et [Etiology]
KW  - Coronary Restenosis/pp [Physiopathology]
KW  - Coronary Vessels/dg [Diagnostic Imaging]
KW  - Coronary Vessels/pp [Physiopathology]
KW  - District of Columbia
KW  - Female
KW  - Humans
KW  - Kaplan-Meier Estimate
KW  - Male
KW  - Middle Aged
KW  - Percutaneous Coronary Intervention/ae [Adverse Effects]
KW  - Recurrence
KW  - Registries
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Time Factors
KW  - Treatment Outcome
KW  - Vascular Patency
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online through MWHC library: 2008 - present
N2  - BACKGROUND: Recurrent DES-ISR remains a therapeutic challenge, and VBT has been used selectively in recurrent DES failure; CONCLUSIONS: VBT for recurrent DES-ISR is safe, with low recurrence rates at 12 months post-procedure, and can be safely used as an effective short-term strategy. Overtime, there is a gradual attrition in patency requiring repeat intervention; Copyright c 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved; METHODS: Patients undergoing VBT for recurrent DES-ISR were enrolled from a percutaneous coronary intervention registry. Clinical, procedural, VBT, and outcome data were collected for DES-ISR treated with radiation. Follow-up was obtained by phone call and clinic visits; OBJECTIVES: The study sought to report safety and long-term clinical efficacy of intravascular brachytherapy (VBT) for recurrent drug-eluting stent in-stent restenosis (DES-ISR); RESULTS: A total of 186 patients (283 lesions) were included. Mean age was 65 +/- 11 years, and 115 (61.8%) were men. Mean time to failure from last failed DES implantation was 450.65 +/- 50 days. Majority (95%) had >2 episodes of target lesion revascularization (TLR). Commonest presentation of DES-ISR was unstable angina (68, 30%). All lesions were treated with balloon angioplasty followed by VBT using Beta-Cath system (Best Vascular Inc., Springfield, Virginia) with a dose of 23 to 25 Gy at 2 mm from source center. Radiation was delivered to site of ISR, without procedural adverse events, in 99% cases. Incidence of TLR was 3.3% at 6 months, 12.1% at 1 year, 19.1% at 2 years, and 20.7% at 3 years. No subacute thrombosis event was noted. One patient had late thrombosis during a 3-year follow-up
UR  - https://dx.doi.org/10.1016/j.jcin.2016.03.018
ER  -