ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2025
Long-term clinical outcomes of intravascular brachytherapy for multilayer drug-eluting in-stent restenosis.
Article in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Practical Management in Coronary In-Stent Restenosis: A Narrative Review.Journal of clinical medicine · 2026Review
- Intracoronary brachytherapy: will it rise from the ashes?EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
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15 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundMultilayer in-stent restenosis (ISR) remains a clinical challenge. Intravascular brachytherapy (IVBT) offers a "metal-free" treatment modality for multilayer drug-eluting stent (DES)-ISR; however, long-term outcome data on IVBT safety and efficacy are lacking.
aimsWe sought to compare 3-year clinical outcomes between patients treated with IVBT and those treated with a non-IVBT strategy.
methodsPatients treated for multilayer DES-ISR (≥2 layers) at Mount Sinai Hospital (2012-2019) were included for analysis. The primary outcome was major adverse cardiac events (MACE), a composite of all-cause death, target lesion revascularisation and myocardial infarction, at 3-year follow-up.
resultsA total of 647 patients (mean age 66.6±9.9 years, 25.5% female) were included: 453 patients (70%) were treated with IVBT and 194 patients (30%) with a non-IVBT strategy. Baseline characteristics were similar, except for IVBT-treated patients having a higher incidence of prior coronary artery bypass grafting. The IVBT group had a lower mean SYNTAX score (11.9±10.7 vs 14.2±11.3; p=0.028) and were significantly less likely to receive a DES (0.4% vs 25.8%; p<0.001). At 3-year follow-up, the incidence of MACE was lower in the IVBT-treated group compared to the non-IVBT group (propensity score-adjusted analysis: 39.5% vs 47.8%; hazard ratio 0.73, 95% confidence interval: 0.53-0.99; p=0.044). There were no significant differences between the incidence of the individual components of MACE in each group.
conclusionsMultilayer DES-ISR is associated with a high rate of adverse outcomes at 3-year follow-up. Treatment with IVBT was associated with a lower rate of MACE compared to treatment with a non-IVBT strategy at long-term follow-up.
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