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Randomized comparison between intracoronary beta-radiation brachytherapy and implantation of paclitaxel-eluting stents for the treatment of diffuse in-stent restenosis.
Schukro, Christoph; Syeda, Bonni; Kirisits, Christian; Schmid, Rainer; Pichler, Philipp; Pokrajac, Boris; Lang, Irene; Pötter, Richard; Glogar, Dietmar.
Afiliación
  • Schukro C; Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria. christoph.schukro@meduniwien.ac.at
Radiother Oncol ; 82(1): 18-23, 2007 Jan.
Article en En | MEDLINE | ID: mdl-16971011
BACKGROUND AND PURPOSE: Intracoronary brachytherapy was the primary therapeutic option for the treatment of in-stent restenosis (ISR) during the last years. Especially for the treatment of diffuse ISR (lesions >10mm), beta-source brachytherapy was significantly superior to singular balloon angioplasty. Despite lacking clinical database, the implantation of drug eluting stents recently became a common procedure for the treatment of ISR. This randomized trial aimed to compare the efficacy of beta-brachytherapy with beta-radioisotopes (90)Sr/(90)Y and paclitaxel-eluting stent implantation for the treatment of diffuse ISR. MATERIAL AND METHODS: Thirty-seven patients with diffuse ISR were randomly assigned to beta-brachytherapy after balloon angioplasty (Beta-Cath in 17 patients) or paclitaxel-eluting stent implantation (Taxus-Express2 in 20 patients). Six-month clinical follow-up was obtained for all patients, while angiographic follow-up was available for 30 patients. RESULTS: Binary ISR (restenosis >50%) within target segment was observed in three patients treated with Beta-Cath, of which one needed target segment revascularisation for recurrent ISR, whereas no significant restenosis occurred in the patients treated with Taxus-Express2 (P=0.037). No further major adverse cardiac (target segment revascularisation, myocardial infarction, death) was found in either group (P=NS). Stent implantation was the more time-saving (31+/-11 min versus 60+/-23 min, P<0.001) procedure. CONCLUSIONS: Although this trial revealed a significant reduction of binary restenosis in the Taxus-Express2 arm, we found no difference in clinical outcome after implantation of paclitaxel-eluting stents for the treatment of diffuse ISR when compared to beta-brachytherapy.
Asunto(s)
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Banco de datos: MEDLINE Asunto principal: Braquiterapia / Stents / Paclitaxel / Reestenosis Coronaria Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Radiother Oncol Año: 2007 Tipo del documento: Article País de afiliación: Austria
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Banco de datos: MEDLINE Asunto principal: Braquiterapia / Stents / Paclitaxel / Reestenosis Coronaria Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Radiother Oncol Año: 2007 Tipo del documento: Article País de afiliación: Austria