06/10/2002 By Anne MacLennan
Regardless of supplementary intravascular brachytherapy, repeat stenting strategies provide little long-term advantage, suggests a study of late vascular response to repeat stenting for in-stent restenosis with and without radiation.
Additional lumen gain from re-stenting in-stent restenosis (ISR) lesions is counteracted by exaggerated neointimal proliferation in placebo patients.
Maximum effectiveness and safety of radiation can be achieved for ISR lesions when treated without re-stenting, conclude authors of this multi-centre study led by Yoshihiro Morino from the Center for Research in Cardiovascular Interventions, Stanford University Medical Center, Stanford, California.
These researchers performed volumetric intravascular ultrasound analysis in 70 ISR lesions that received either placebo (36 patients) or radiation (34 patients). The ISR lesions treated by re-stenting were divided into three segments.
These were: old stent not re-stented (segment A), old/new stent overlap (segment B) and new stent only (segment C). Lesions treated without re-stenting were categorized as D.
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