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The IST registry.

Sigmund Silber1, Dietrich Baumgart, Christoph Hehrlein

  • 1Dr. Müller Hospital, Am Isarkanal 36, 81379 Munich, Germany. silber@med.de

Zeitschrift Fur Kardiologie
|March 19, 2003
PubMed
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Intracoronary brachytherapy effectively treats in-stent restenosis. Long-term data from the IST Registry show late vessel occlusion can occur, necessitating aspirin plus clopidogrel for at least one year.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Radiation Oncology

Background:

  • Intracoronary brachytherapy is an established treatment for in-stent restenosis in Europe and the US.
  • The German IST Registry was established to track patients undergoing this procedure.

Purpose of the Study:

  • To register all patients treated with intracoronary radiation in Germany.
  • To observe the clinical outcome of these patients for five years.
  • To collect minimal data to encourage participation and facilitate online data entry and comparison.

Main Methods:

  • Prospective registry of patients undergoing intracoronary brachytherapy.
  • Data collection on clinical outcomes over a 5-year period.
  • Analysis of initial data from 332 radiated stenoses.

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Main Results:

  • Late vessel occlusion was observed even after 6 months of clopidogrel plus aspirin therapy without new stent implantation.
  • Approximately 270 patients per month receive intracoronary radiation in Germany.
  • The Novoste System is used in 58 labs, Guidant in 16, and Cordis-Gamma in one due to strict safety regulations.

Conclusions:

  • Extended antiplatelet therapy (aspirin plus clopidogrel) for at least one year is recommended after intracoronary brachytherapy.
  • The IST Registry will provide crucial long-term data for future negotiations with healthcare insurers.
  • The registry serves as a comparative database for long-term outcomes, including those with antiproliferative-coated stents.