Authors' objectives:

This review aims to assess the available evidence on the effectiveness of intracoronary brachytherapy to treat restenosis after stent placement (in-stent restenosis).

Authors' recommendations: With regard to intracoronary brachytherapy to treat in-stent restenosis, the ICSI Technology Assessment Committee finds that: Intracoronary brachytherapy with catheter based gamma and beta radiation has consistently been shown in prospective, randomized trials to decrease the rate of restenosis in previously stented native coronary arteries up to 12 months post-treatment. (Conclusion Grade I) Intracoronary brachytherapy followed by antiplatelet therapy has shown no statistically significant added risk of death or MI compared to percutaneous intervention in the same vessel. Intracoronary brachytherapy may increase the risk of late thrombosis. Thus, the use of antiplatelet therapy with ticlopidine or clopidogrel in addition to aspirin for 6-12 months post-treatment may be advisable but needs further study. Long-term safety and efficacy (beyond 2 years) of intracoronary brachytherapy are unknown at this time. No survival benefit has been observed or is expected; the benefit is relief of angina.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.icsi.org/index.asp

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Institute for Clinical Systems Improvement

Contact Address: 8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675

Contact Name: icsi.info@icsi.org

Contact Email: icsi.info@icsi.org

Copyright: Institute for Clinical Systems Improvement (ICSI)