OBJECTIVE: We undertook a meta-analysis of randomised trials assessing the outcome of vascular brachytherapy (VBT) or DES for the treatment of coronary artery ISR. METHODS AND RESULTS: Studies utilising DES or VBT for ISR were identified by a systematic search. Data was pooled and combined overall effect measures were calculated for a random effect model in terms of deaths, myocardial infarctions, revascularisation, binary restenosis, mean late luminal loss and major adverse cardiac events (MACE). Fourteen eligible studies (3103 patients) were included. Neither therapy had any effect on mortality or myocardial infarction rate. VBT reduced the rate of revascularisation (RR 0.59, 95%CI 0.50-0.68), MACE (RR 0.58, 95%CI 0.51-0.67), binary restenosis (RR 0.51, 95%CI 0.44-0.59) and late loss (-0.73 mm, 95%CI -0.91 to -0.55 mm) compared to balloon angioplasty and selective bare metal stents (BMS) alone at intermediate follow-up and MACE (RR 0.72, 95%CI 0.61-0.85) at long-term follow-up. DES reduced the rate of revascularisation (OR 0.51, 95% CI 0.36-0.71), MACE (OR 0.55, 95% CI 0.39-0.79) and binary restenosis (OR 0.57, 95% CI 0.40-0.81) compared to VBT but follow-up was limited to 9 months. CONCLUSIONS: VBT improves the long-term outcome of angioplasty compared with BMS alone in the treatment of ISR. DES appears to provide similar results to that of VBT during short-term follow-up.
OBJECTIVE: We undertook a meta-analysis of randomised trials assessing the outcome of vascular brachytherapy (VBT) or DES for the treatment of coronary artery ISR. METHODS AND RESULTS: Studies utilising DES or VBT for ISR were identified by a systematic search. Data was pooled and combined overall effect measures were calculated for a random effect model in terms of deaths, myocardial infarctions, revascularisation, binary restenosis, mean late luminal loss and major adverse cardiac events (MACE). Fourteen eligible studies (3103 patients) were included. Neither therapy had any effect on mortality or myocardial infarction rate. VBT reduced the rate of revascularisation (RR 0.59, 95%CI 0.50-0.68), MACE (RR 0.58, 95%CI 0.51-0.67), binary restenosis (RR 0.51, 95%CI 0.44-0.59) and late loss (-0.73 mm, 95%CI -0.91 to -0.55 mm) compared to balloon angioplasty and selective bare metal stents (BMS) alone at intermediate follow-up and MACE (RR 0.72, 95%CI 0.61-0.85) at long-term follow-up. DES reduced the rate of revascularisation (OR 0.51, 95% CI 0.36-0.71), MACE (OR 0.55, 95% CI 0.39-0.79) and binary restenosis (OR 0.57, 95% CI 0.40-0.81) compared to VBT but follow-up was limited to 9 months. CONCLUSIONS: VBT improves the long-term outcome of angioplasty compared with BMS alone in the treatment of ISR. DES appears to provide similar results to that of VBT during short-term follow-up.
Authors: R Waksman; R L White; R C Chan; B G Bass; L Geirlach; G S Mintz; L F Satler; R Mehran; P W Serruys; A J Lansky; P Fitzgerald; B Bhargava; K M Kent; A D Pichard; M B Leon Journal: Circulation Date: 2000-05-09 Impact factor: 29.690
Authors: H Schühlen; N Eigler; J S Whiting; R Haubner; J Hausleiter; J Dirschinger; A Kastrati; M Schwaiger; A Schömig Journal: Am J Cardiol Date: 2001-02-15 Impact factor: 2.778
Authors: Juergen vom Dahl; Ulrich Dietz; Philipp K Haager; Sigmund Silber; Luigi Niccoli; Hans Juergen Buettner; Francois Schiele; Martyn Thomas; Philippe Commeau; David R Ramsdale; Eulogio Garcia; Christian W Hamm; Rainer Hoffmann; Thorsten Reineke; Heinrich G Klues Journal: Circulation Date: 2002-02-05 Impact factor: 29.690
Authors: Ron Waksman; Andrew E Ajani; R Larry White; Rosanna C Chan; Lowell F Satler; Kenneth M Kent; Augusto D Pichard; Ellen E Pinnow; Anh B Bui; Steven Ramee; Paul Teirstein; Joseph Lindsay Journal: N Engl J Med Date: 2002-04-18 Impact factor: 91.245
Authors: A E Raizner; S N Oesterle; R Waksman; P W Serruys; A Colombo; Y L Lim; A C Yeung; W J van der Giessen; L Vandertie; J K Chiu; L R White; P J Fitzgerald; G L Kaluza; N M Ali Journal: Circulation Date: 2000-08-29 Impact factor: 29.690
Authors: P S Teirstein; V Massullo; S Jani; J J Popma; R J Russo; R A Schatz; E M Guarneri; S Steuterman; K Sirkin; D A Cloutier; M B Leon; P Tripuraneni Journal: Circulation Date: 2000-02-01 Impact factor: 29.690