Intracoronary brachytherapy for the treatment of recurrent drugeluting stent in-stent restenosis:A systematic review and metaanalysis  

作　　者：Irtqa Ilyas Ashish Kumar Devina Adalja Mariam Shariff Rupak Desai Yasar Sattar Saraschandra Vallabhajosyula Nageshwara Gullapalli Rajkumar Doshi 

机构地区：[1]Department ofInternal Medicine,University of Nevada Reno School of Medicine,Reno,NV 89509,United States [2]Department of Critical Care Medicine,Saint John's Medical College Hospital,Bangalore 560034,Karnataka,India [3]Department of Internal Medicine,GMERS Gotri Medical College,Vadodara 380021,Gujarat,India [4]Department of Cardiology,Atlanta VA Medical Center,Decatur,GA 30033,United States [5]Department of Internal Medicine,Icahn School of Medicine at Mount Sinai Elmhurst,New York,NY 11373,United States [6]Interventional Cardiology,Emory University,Atlanta,GA 30322,United States

出　　处：《World Journal of Cardiology》2021年第4期95-102,共8页世界心脏病学杂志（英文版）（电子版）

摘　　要：BACKGROUND We performed a meta-analysis on observational studies since randomized control trials are not available.We studied intracoronary brachytherapy(ICBT)and recurrent drug eluting stent in-stent restenosis(DES-ISR)to evaluate the procedural success,target lesion revascularization(TLR),incidence of myocardial infarction(MI)and all-cause mortality at 2 years follow-up.AIM To perform meta-analysis for patients undergoing ICBT for recurrent DES-ISR.METHODS We performed a systematic search of the PubMed/MEDLINE,Cochrane and DARE databases to identify relevant articles.Studies were excluded if intracoronary brachytherapy was used as a treatment modality for initial ISR and studies with bare metal stents.We used a random-effect model with DerSimonian&Laird method to calculate summary estimates.Heterogeneity was assessed using I2 statistics.RESULTS A total of 6 observational studies were included in the final analysis.Procedural angiographic success following intra-coronary brachytherapy was 99.8%.Incidence of MI at 1-year was 2%and 4.1%at 2-years,respectively.The incidence of TLR 14.1%at 1-year and 22.7%at 2-years,respectively.All-cause mortality at 1-and 2-year follow-up was 3%and 7.5%,respectively.CONCLUSION Given the observational nature of the studies included in the analysis,heterogeneity was significantly higher for outcomes.While there are no randomized controlled trials or definitive guidelines available for recurrent ISR associated with DES,this analysis suggests that brachytherapy might be the alternative approach for recurrent DES-ISR.Randomized controlled trials are required to confirm results from this study.

关 键 词：Intracoronary brachytherapy In-stent restenosis META-ANALYSIS Drug eluting stent Systematic review BRACHYTHERAPY 

分 类 号：R654.2[医药卫生—外科学]