title: Debulking for in-stent restenosis in the brachytherapy era: does it still have a role?
abstract: Despite the advent of intracoronary brachytherapy, treatment of in-stent restenosis, particularly diffuse in-stent restenosis, remains problematic. Adjunctive debulking prior to brachytherapy may improve long-term outcomes. We review the literature and report our results of a series of patients treated with excimer laser coronary atherectomy along with balloon angioplasty and brachytherapy for in-stent restenosis. We conclude that adjunctive debulking may improve the long-term clinical outcomes of patients with diffuse in-stent restenosis treated with angioplasty and intracoronary radiation. A randomized controlled trial is warranted.
authors.affiliation: Emory University Hospital, Cardiac Catheterization Laboratory, Suite C430, 1364 Clifton Road N.E., Atlanta, GA 30322, USA.
authors.forename: Ajay
authors.initials: A
authors.lastname: Tuli
authors.forename: Veerappan
authors.initials: V
authors.lastname: Subramaniyam
authors.forename: Stephen
authors.initials: S
authors.lastname: Bakir
authors.forename: Peter C
authors.initials: PC
authors.lastname: Block
authors.forename: Ian R
authors.initials: IR
authors.lastname: Crocker
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000639:trends; D019917:Blood Vessel Prosthesis Implantation / Q000639:trends; D001918:Brachytherapy / Q000639:trends*; D023903:Coronary Restenosis / Q000628:therapy*; D006801:Humans; D015607:Stents; D016896:Treatment Outcome