Clinical outcomes for sirolimus-eluting stent implantation and vascular brachytherapy for the treatment of in-stent restenosis.
The purpose of this study was to compare the mid-term clinical outcome of sirolimus-eluting stent (SES) implantation and vascular brachytherapy (VBT) for in-stent restenosis (ISR). We assessed the 9-month occurrence of major adverse cardiac events (MACE) in 44 consecutive patients with ISR treated with SES implantation and 43 consecutive patients treated with VBT in the period immediately prior. Baseline clinical and angiographic characteristics of the two groups were similar. During follow-up, three patients (7%) died in the VBT group and none in the SES group. The incidence of myocardial infarction was 2.3% in both groups. Target lesion revascularization was performed in 11.6% of the VBT patients and 16.3% of the SES patients (P = NS). The 9-month MACE-free survival was similar in both groups (79.1% VBT vs. 81.5% SES; P = 0.8 by log rank). The result of this nonrandomized study suggests that sirolimus-eluting stent implantation is at least as effective as vascular brachytherapy in the treatment of in-stent restenosis.
Saia
Francesco
F
Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
Lemos
Pedro A
PA
Hoye
Angela
A
Sianos
Georgios
G
Arampatzis
Chourmouzios A
CA
de Feyter
Pim J
PJ
van der Giessen
Willem J
WJ
Smits
Pieter C
PC
van Domburg
Ron T
RT
Serruys
Patrick W
PW
D001918:Brachytherapy; D016009:Chi-Square Distribution; D023903:Coronary Restenosis / Q000188:drug therapy* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D020123:Sirolimus