"Effects of Residual In-Stent Restenosis Following Intra-Coronary Brach" by Nicholas P. Kondoleon, Matthew Hanna et al.
 

Effects of Residual In-Stent Restenosis Following Intra-Coronary Brachytherapy

Document Type

Conference Proceeding

Publication Date

5-2025

Publication Title

Journal of the Society for Cardiovascular Angiography and Interventions

Abstract

Background: Drug eluting stents (DES) are widely used for acute and stable ischemic coronary disease. One complication, multifactorial in etiology, is resultant in-stent restenosis (ISR). In patients with ISR, not amenable to further DES or bypass surgery, intra-coronary brachytherapy (ICBT) remains an option for treatment. This study aims to evaluate outcomes for patients that have residual ISR following ICBT. Methods: This was a single center, retrospective, study including 248 patients who underwent ICBT for multilayer ISR from September 2014 to May 2023. Kaplan Meier analysis was utilized to assess primary endpoints of MACE, including myocardial infarction, target lesion revascularization (TLR), and death, at one, three, and five years for patients with < 25% and >25% residual ISR following ICBT. Results: 239 patients were included comparing 186 patients with < 25% and 53 patients with >25% residual ISR following ICBT. Survival analysis showed no difference in mortality at one (p¼0.91), three (p¼0.44), and five years (p¼0.41). In patients with >25% residual ISR, Kaplan Meier estimator showed higher incidence of MACE that was statistically significant at one year (p¼0.0046) and persisted to year three (p¼0.049) and five (p¼0.023). Analysis of TLR revealed statistical significance at one year (p¼0.025) that did not persist to year three (p¼0.18) and five (p¼0.14) (Figure 1). Conclusions: >25% residual ISR following ICBT is shown to have higher MACE event rates at one, three, and five years with statistical significance. There was no difference in mortality, however, TLR event rates were higher in patients with >25% residual ISR at one year following procedure.

Volume

4

Issue

5 Suppl

First Page

38

Comments

Society for Cardiovascular Angiography and Interventions SCAI 48th Annual Scientific Sessions, May 1-3, 2025, Washington, DC

Last Page

39

DOI

10.1016/j.jscai.2025.103206

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