Intravascular radiation therapy appears to be a helpful approach in treatment of in-stent restenosis (ISR) in patients. NEW YORK (Reuters Health) - Intravascular radiation therapy appears to be a helpful approach in treatment of in-stent restenosis (ISR) in patients, who, despite having received drug-eluting stents (DES) still experience this problem, according to researchers. The outcome is superior to that with repeat DES.

"In-stent restenosis of DES occurs in nearly 10% of all DES implanted over time," senior investigator Dr. Ron Waksman told Reuters Health. "Although not diffuse as with bare metal stents, DES ISR still associated with late events."

To investigate further, the researchers note in the November 15th issue of the American Journal of Cardiology, that they compared outcomes in 61 patients who had intravascular brachytherapy for the condition, with those of 50 patients who were assigned to repeat DES treatment.

At 8 months, in the repeat DES group, 18% required target vessel revascularization and 8% required target lesion revascularization. Corresponding proportions in the radiation group were 10% for both. [tab3]

In addition, 24% of DES patients experienced major cardiovascular events compared to 9.8% of radiation patients.

Thus, concluded, Dr. Waksman, "vascular brachytherapy is a safe and effective therapy for ISR of DES and seems to have better results when compared to treatment using DES" for such restenosis.

Am J Cardiol 2006;98:1340-1344.