Intracoronary brachytherapy for the treatment of recurrent drug-eluting stent in-stent restenosis: A systematic review and meta-analysis.
Brachytherapy
Drug eluting stent
In-stent restenosis
Intracoronary brachytherapy
Meta-analysis
Systematic review
Journal
World journal of cardiology
ISSN: 1949-8462
Titre abrégé: World J Cardiol
Pays: United States
ID NLM: 101537090
Informations de publication
Date de publication:
26 Apr 2021
26 Apr 2021
Historique:
received:
13
12
2020
revised:
08
03
2021
accepted:
22
03
2021
entrez:
10
5
2021
pubmed:
11
5
2021
medline:
11
5
2021
Statut:
ppublish
Résumé
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. To perform meta-analysis for patients undergoing ICBT for recurrent DES-ISR. We performed a systematic search of the PubMed/MEDLINE, Cochrane and DARE databases to identify relevant articles. Studies were excluded if intra-coronary 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 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. 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.
Sections du résumé
BACKGROUND
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
OBJECTIVE
To perform meta-analysis for patients undergoing ICBT for recurrent DES-ISR.
METHODS
METHODS
We performed a systematic search of the PubMed/MEDLINE, Cochrane and DARE databases to identify relevant articles. Studies were excluded if intra-coronary 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
RESULTS
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
CONCLUSIONS
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.
Identifiants
pubmed: 33968308
doi: 10.4330/wjc.v13.i4.95
pmc: PMC8069516
doi:
Types de publication
Journal Article
Langues
eng
Pagination
95-102Informations de copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: There is no conflict of interest for any of the author in this manuscript.
Références
J Geriatr Cardiol. 2018 Feb;15(2):173-184
pubmed: 29662511
JACC Cardiovasc Interv. 2016 Jun 27;9(12):1259-1265
pubmed: 27339842
N Engl J Med. 2007 Mar 8;356(10):989-97
pubmed: 17296825
Eur Heart J. 2019 Jan 7;40(2):87-165
pubmed: 30165437
Korean Circ J. 2018 May;48(5):337-349
pubmed: 29737639
J Am Coll Cardiol. 2002 Apr 17;39(8):1290-6
pubmed: 11955846
Catheter Cardiovasc Interv. 2021 Jan 1;97(1):32-38
pubmed: 31943747
Adv Radiat Oncol. 2015 Dec 19;1(1):4-9
pubmed: 28799576
Circulation. 2000 Dec 12;102(24):2915-8
pubmed: 11113039
Circ Cardiovasc Interv. 2018 Oct;11(10):e006832
pubmed: 30354630
Circ Res. 2002 Mar 8;90(4):398-404
pubmed: 11884368
PLoS Med. 2009 Jul 21;6(7):e1000100
pubmed: 19621070
Catheter Cardiovasc Interv. 2021 Jan 1;97(1):41-46
pubmed: 31930652
J Am Coll Cardiol. 1997 Nov 15;30(6):1428-36
pubmed: 9362398
Circulation. 2011 Dec 6;124(23):e574-651
pubmed: 22064601
Am J Cardiol. 2017 Aug 1;120(3):369-373
pubmed: 28583681