Poor outcome in patients treated with brachytherapy for diffuse in-stent restenosis. The role of additional stenting despite prolonged antiplatelet therapy.

Background: Brachytherapy (IBT) has been the first effective treatment of in-stent restenosis (ISR). However, when IBT is associated with additional stenting, high rates of late thrombosis have been observed. Even though prolongation of a double antiplatelet therapy seems to have overcome this problem, studies analyzing whether additional stenting still remains a negative prognostic factor for restenosis are lacking.

Is conventional antiplatelet therapy for the prevention of coronary stent thrombosis always safe? A case report of a patient with polycythemia vera.

A 63-year-old male patient with both polycythemia vera and unstable angina underwent an angioplasty with the deployment of a stent. Conventional antiplatelet therapy failed to prevent stent thrombosis and an association with chronic anticoagulation seemed to be the only safe treatment. Moreover, after the late withdrawal of warfarin, stent thrombosis recurred.

Immediate and late results of coronary angioplasty in patients with severe left ventricular dysfunction.

Background: Severe coronary artery disease in patients with a markedly depressed left ventricular function is associated with a poor prognosis. Even though coronary angioplasty (PTCA) has been offered as an alternative to bypass surgery, the role of PTCA in the treatment of patients with severe left ventricular dysfunction has not been well defined. The aim of the present study was to evaluate the immediate and long-term results in patients with severe left ventricular dysfunction < or = 35% who underwent PTCA.

Intracoronary beta-radiation for the treatment of patients at very high risk for recurrence of in-stent restenosis: a single center experience.

Background: Intracoronary brachytherapy has significantly reduced the recurrence of in-stent restenosis. The aim of this study was to evaluate the feasibility, safety and efficacy of intracoronary beta-radiation in patients at very high risk for recurrence of in-stent restenosis.

Methods: We analyzed 42 patients with 50 lesions submitted to catheter-based beta-radiation (Beta-Cath System, Novoste Corporation, Norcross, GA, USA) for in-stent restenosis.

Recanalization of chronic total coronary occlusions: the impact of a new specific guidewire on primary success rate.

BACKGROUND: Although chronic total occlusions are encountered frequently in patients with coronary artery disease, an effective strategy to deal with them has yet to be devised. Various new guidewires have been designed in an attempt to negotiate chronic occlusions successfully. The authors have analysed the impact of the Athlete guidewire on procedural success in this lesion subset.