Background: Intravascular brachytherapy (VBT) is an established treatment for the management of in-stent restenosis (ISR). However, whether VBT is associated with improved patient reported outcomes unknown.
Methods: We evaluated 51 consecutive patients undergoing VBT in one or more coronary arteries from January 2018 to September 2019. Data on baseline characteristics, procedural outcomes and adverse events were obtained. All patients completed the Seattle Angina Questionnaire - 7 (SAQ-7) form before and after VBT at 1 month and 6 months.
Results: The mean age was 69 ± 9 years and 29 (57%) of patients were males. Procedural success was 94.1%. The mean summary SAQ-7 score improved significantly (53.2 ± 21 vs. 83 ± 19, p < .001) at 30-days. The median Quality of Life (QoL) component of SAQ-7 score was 31.3 (Interquartile Range [IQR]: 18.8, 62.5) and improved to 82.5 (IQR: 62.5, 100), p < .001 at 30 days and 87.5 [IQR: 75, 100), p < .001 at last follow up. Likewise, the median angina frequency component of the SQL-7 score pre-VBT was 55 (IQR: 45, 80) and improved significantly to 90 (IQR: 60, 100) at 30-days, p < .001 and 100 [IQR: 68.8, 100], p = .02 at last follow up. Lastly, the median activity component of the SAQ-7 score improved from 83.3 (IQR: 60-100) to 100 (IQR: 83, 100), p = .01 at 30-days. Thus, results were evident as early as 1 month and sustained at median follow up of 17 months.
Conclusion: VBT is associated with improvement in patient reported outcome measures at short term and long term follow up.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.carrev.2020.05.032 | DOI Listing |
Rev Cardiovasc Med
December 2024
Department of Cardiology, Bern University Hospital, Inselspital, CH-3010 Bern, Switzerland.
In-stent restenosis (ISR) remains the predominant cause of stent failure and the most common indication for repeat revascularization. Despite technological advances in stent design, ISR continues to pose significant challenges, contributing to increased morbidity and mortality among patients undergoing percutaneous coronary interventions. In the last decade, intravascular imaging has emerged as an important method for identifying the mechanisms behind ISR and guiding its treatment.
View Article and Find Full Text PDFBrachytherapy
January 2025
Department of Radiation Oncology, University of Washington, Seattle, WA.
Introduction: There is some evidence of a dose-response relationship for intravascular brachytherapy (IVBT) of native vessel or first-time in-stent restenosis (ISR). It has also been shown that in-field failure predominates following intravascular brachytherapy-treated lesions. Accordingly, it may be advantageous to increase the radiation dose(s) currently used.
View Article and Find Full Text PDFMed Phys
November 2024
Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
Background: Coronary artery disease is the most common form of cardiovascular disease. It is caused by excess plaque along the arterial wall, blocking blood flow to the heart (stenosis). A percutaneous coronary intervention widens the arterial wall with the inflation of a balloon inside the lesion area and leaves behind a metal stent to prevent re-narrowing of the artery (restenosis).
View Article and Find Full Text PDFDiagnostics (Basel)
January 2024
Department of Internal Medicine, Chung Shan Medical University Hospital, Chung Shan Medical University, Taichung 40201, Taiwan.
The black hole (BH) phenomenon is an intraluminal restenotic lesion. It was identified by intravascular ultrasound (IVUS) and optical coherence tomography (OCT) after intracoronary brachytherapy and drug-eluting stent implantation. Despite the similarity in the mode of action of brachytherapy and drug-eluting stent implantation, the BH phenomenon appears to be uncommon after drug-eluting stent implantation.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
November 2023
Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA.
Background: Most randomized studies testing the effectiveness of IVBT were limited to vessels less than 4 mm diameter. In fact, it is now common to treat vessels larger than 4 mm. Accordingly, the authors instituted a prescription dose increase to 34 Gy at 2 mm from source center for vessels greater than 4.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!