Related Experiment Video
Updated: Jan 10, 2026
04:30
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
26.2K
Intravascular Brachytherapy for In-Stent Restenosis in Patients With Chronic Kidney Disease
Gal Sella1,2, Chloe Kharsa2, Mangesh Kritya2
1The Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University of Jerusalem, Israel.
Journal of the Society for Cardiovascular Angiography & Interventions
|November 21, 2025
Summary
Patients with chronic kidney disease (CKD) face higher risks after vascular brachytherapy for in-stent restenosis (ISR). This highlights the need for tailored strategies to manage major adverse cardiovascular events (MACE) in this high-risk group.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- In-stent restenosis (ISR) is a significant challenge in coronary interventions.
- Patients with chronic kidney disease (CKD) have unique inflammatory responses and vascular calcification.
- Vascular brachytherapy is being reconsidered for recurrent ISR.
Purpose of the Study:
- To evaluate the clinical outcomes of vascular brachytherapy for ISR.
- To compare outcomes between patients with and without CKD.
Main Methods:
- Retrospective analysis of 227 patients (54 CKD, 173 non-CKD) undergoing vascular brachytherapy for ISR.
- CKD defined as eGFR <60 mL/min/1.73 m² for ≥3 months.
- Primary endpoint: target lesion revascularization (TLR). Secondary endpoints: major adverse cardiovascular events (MACE), all-cause mortality at 1 year.
Main Results:
- CKD patients had higher 1-year MACE rates (63.0% vs 32.9%, P=.0003), driven by increased TLR (31.5% vs 17.9%, P=.038).
- Bleeding complications occurred only in the CKD group (5.6%).
- Male sex was associated with lower TLR risk in CKD patients (HR 0.15, P=.010).
Conclusions:
- Patients with CKD experience significantly worse outcomes after vascular brachytherapy for ISR.
- CKD's inflammatory environment may counteract brachytherapy's benefits, leading to higher MACE and TLR.
- Refined interventional strategies and risk management are crucial for CKD patients undergoing this procedure.
Related Concept Videos
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
249
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
249
01:28Chronic Kidney Disease III: Interprofessional Care
326
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
326
01:20Acute Kidney Injury V: Interprofessional Care
284
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
284
01:18Chronic Kidney Disease IV: Nursing Management
307
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
307
01:30Continuous Renal Replacement Therapy
768
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
768
01:19Imaging Studies VII: Vascular Imaging
294
DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
294