Three-Year Clinical Follow-Up After Strontium-90/Yttrium-90 Beta-Irradiation for the Treatment of In-Stent Coronary Restenosis

Baierl, Verena; Baumgartner, Stephan; Pöllinger, Barbara; Leibig, Marcus; Rieber, Johannes; König, Andreas; Krötz, Florian; Sohn, Hae-Young; Siebert, Uwe; Haimerl, Wolfgang; Dühmke, Eckhart; Theisen, K.; Klauß, Volker; Schiele, Thomas M.

doi:10.1016/j.amjcard.2005.06.087

Cited by 21 publications

(13 citation statements)

References 24 publications

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“…The adjusted TVR curves remained roughly parallel between 1 and 2 years, confirming lasting benefits of DES and excluding a brachytherapy-like catchup phenomenon. 23 Nevertheless, the extent of the 2-year reduction in need for TVR (34%) may appear rather low, especially in light of the 66% decrease in need for target lesion revascularization reported in a meta-analysis of data on diabetic patients enrolled in randomized trials. 7 Here again, however, regular angiographic monitoring could have greatly accentuated the recorded benefits.…”

Section: Ortolani Et Al Drug-eluting Stents In Diabetic Patientsmentioning

confidence: 99%

Two-Year Clinical Outcomes With Drug-Eluting Stents for Diabetic Patients With De Novo Coronary Lesions

et al. 2008

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Background-The long-term effectiveness of drug-eluting stents (DES) in unselected diabetics in routine practice is currently unclear. Methods and Results-To evaluate the long-term effectiveness of bare metal stents and DES in a real-world setting of diabetic patients, we analyzed 2-year follow-up data from all diabetic patients with de novo lesions enrolled in a prospective Web-based multicenter registry (Registro Regionale Angioplastiche dell'Emilia-Romagna; study period, 2002 to 2004) comprising all 13 hospitals performing percutaneous coronary interventions in the Emilia-Romagna region of Italy. Among the 1648 eligible patients treated with either bare metal stents alone (nϭ1089) or DES alone (nϭ559), 27% were insulin dependent and 83% had multivessel coronary disease. At 2 years, use of DES was associated with lower crude incidence of major adverse cardiac advents (all-cause mortality, nonfatal myocardial infarction, and target vessel revascularization) compared with bare metal stents (22.5% versus 28.1%; Pϭ0.01). After propensity score adjustment, only target vessel revascularization appeared significantly lower in the DES group (11.6% versus 15.0%; hazard ratio, 0.66; 95% confidence interval, 0.46 to 0.96; Pϭ0.041). Two-year angiographic stent thrombosis occurred in 1.5% DES patients and 0.7% of the bare-metal-stents patients (Pϭ0.18). At Cox regression analysis, predictors of 2-year major adverse cardiac advents were left ventricular ejection fraction Ͻ35%, Charlson comorbidity index, insulin-dependent diabetes, and total lesion length. Conclusions-In this large, real-world, diabetic population, the use of DES was associated with a moderate reduction in the 2-year risk of target vessel revascularization, a benefit that was limited to non-insulin-dependent diabetic patients. Larger long-term studies are needed to clarify the long-term effectiveness and safety of such devices in diabetic patients.

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Section: Ortolani Et Al Drug-eluting Stents In Diabetic Patientsmentioning

confidence: 99%

Two-Year Clinical Outcomes With Drug-Eluting Stents for Diabetic Patients With De Novo Coronary Lesions

et al. 2008

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“…bosis and restenosis. [13][14][15] These limitations have resulted in a shift away from VBT for treatment of ISR in daily clinical practice despite the absence of a proven therapeutic alternative.…”

mentioning

confidence: 99%

Paclitaxel-Eluting Stents vs Vascular Brachytherapy for In-Stent Restenosis Within Bare-Metal Stents

Stone¹,

Ellis²,

O’Shaughnessy³

et al. 2006

JAMA

257

145

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“…Early results from registries show that the 1‐year incidence rate of repeat revascularization after DES implantation was 2% to 19%, compared with 12% to 31% with BMSs (Table I). Furthermore, the incidence of repeat revascularization remained steady up to 2 years without the “late catch‐up” phenomenon of late restenosis, which had been noted after coronary brachytherapy 14 …”

Section: Dess For Unprotected Lmca Interventionmentioning

confidence: 87%

Drug-Eluting Stents for Left Main Coronary Artery Stenosis: Case Selection and Technical Issues

Park

2008

Amer Heart Hosp J

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The use of coronary stents for the treatment of left main coronary artery (LMCA) stenosis is feasible and is associated with a high rate of procedural success and low rates of early and late complications, such as death, myocardial infarction, and stent thrombosis, in low-risk patient populations. Patients at high risk for coronary artery bypass grafting (CABG), however, have reduced event-free survival after stenting. Compared with bare-metal stents for LMCA disease, the subsequent rate of target lesion revascularization appears to be diminished by use of drug-eluting stents (DESs), with similar or enhanced survival and freedom from myocardial infarction. Intravascular ultrasonographic guidance during the procedure is strongly encouraged to assess the lesion, select an appropriate stenting technique, and achieve optimal stent placement. Results of prospective randomized trials comparing the use of DESs with CABG may be needed to ascertain whether DESs could be a reasonable alternative for patients with LMCA disease.

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Three-Year Clinical Follow-Up After Strontium-90/Yttrium-90 Beta-Irradiation for the Treatment of In-Stent Coronary Restenosis

Cited by 21 publications

References 24 publications

Two-Year Clinical Outcomes With Drug-Eluting Stents for Diabetic Patients With De Novo Coronary Lesions

Two-Year Clinical Outcomes With Drug-Eluting Stents for Diabetic Patients With De Novo Coronary Lesions

Paclitaxel-Eluting Stents vs Vascular Brachytherapy for In-Stent Restenosis Within Bare-Metal Stents

Drug-Eluting Stents for Left Main Coronary Artery Stenosis: Case Selection and Technical Issues

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