Comparison between sirolimus-eluting stents and intracoronary catheter-based beta radiation for the treatment of in-stent restenosis
Am J Cardiol
; 96(12): 1656-1662, 15 dec 2005.
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1059435
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
We report the outcomes of patients who had in-stent restenosis (IRS) that was treated with intravascular brachytherapy (IVBT) or sirolimus-eluting stent (SES) implantation. The benefit of IVBT for treating ISR is well documented. SES implantation decreases first-time ISR and, in preliminary reports, has been used to treat ISR. Fifty consecutive patients who had ISR were treated; the first 25 patients underwent SES implantation and the next 25 patients were treated with IVBT using a -Cath System (a 40-mm strontium-90/yttrium-90 source). Quantitative angiographic and intravascular ultrasound follow-up were performed at 5.2 1.1 and 12.1 1.2 months; clinical follow-up was performed at 15 months. SES deployment and IVBT were successful in all patients. At 12-month follow-up, 8 patients who underwent IVBT had angiographic recurrence (4 in the stent and 4 at the stent edge); only 1 patient who underwent SES implantation developed recurrent ISR. At 12 months, in-stent late luminal loss was similar between the SES and IVBT groups (0.35 0.45 vs 0.34 0.46 mm, p 0.9); however, in-stent net luminal gain was higher in the SES group than in the IVBT group (1.32 0.13 vs 0.57 0.19 mm, p <0.0001), and in-lesion late luminal loss was higher in the IVBT group (0.48 0.32 vs 0.16 0.42 mm, p 0.004). At 12 months, intravascular ultrasound stent volume obstruction was higher after IVBT versus than after SES implantation (38.7% vs 6.7%, p <0.0001). At 15-month clinical follow-up, 64% and 96% (p <0.01) of patients who underwent IVBT and SES implantation, respectively, were free of major adverse cardiac events. In conclusion SES implantation for the treatment of ISR was effective and superior to catheter-based IVBT in preventing recurrent neointimal proliferation and angiographic restenosis at 1-year follow-up.
Buscar no Google
Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Cateterismo
/
Stents
/
Reestenose Coronária
Idioma:
Inglês
Revista:
Am J Cardiol
Ano de publicação:
2005
Tipo de documento:
Artigo
Instituição/País de afiliação:
Cardiovascular Research Foundation/US
/
Insituto Dante Pazzanese de Cardiologia/BR