{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T06:19:23Z","timestamp":1771222763803,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In\u2010stent restenosis (ISR) remains a significant challenge in interventional cardiology, with limited long\u2010term effective treatment options. Intravascular brachytherapy (IVB) has reemerged as a viable treatment modality for ISR, yet predictors of treatment failure remain poorly characterized. This study evaluates the clinical outcomes and identifies predictors of failure following IVB in patients with coronary ISR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the clinical outcomes of intravascular brachytherapy for in\u2010stent restenosis and to identify predictors of treatment response. We hypothesized that specific baseline patient characteristics and procedural factors would be associated with clinical response to IVB at one\u2010 and three\u2010year follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 199 patients (226 lesions) who underwent IVB for coronary ISR between June 2016 and January 2024 at our institution. Patients were stratified based on clinical response at 1 year: responders (absence of target lesion revascularization [TLR]) and nonresponders (presence of TLR). The primary endpoint was TLR at 1 year. Secondary endpoints included major adverse cardiovascular events (MACE), net adverse cardiovascular events (NACE), thrombosis, bleeding complications, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 1\u2010year follow\u2010up, 186 lesions (82.3%) were classified as responders and 40 (17.7%) as nonresponders. Baseline demographic characteristics were similar between groups. Angiographic and procedural characteristics were not significantly different between groups. Nonresponders experienced significantly higher rates of thrombosis (7.5% vs. 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), cardiac hospitalization (82.5% vs. 21.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), myocardial infarction (37.5% vs. 2.15%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), all\u2010cause mortality (12.5% vs. 3.23%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), and cardiac death (12.5% vs. 1.09%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Stent implantation was comparable (15% vs. 18.28%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.62). In multivariate analysis, no baseline or procedural characteristics were significant predictors of TLR. However, stent implantation was associated with increased 3\u2010year all\u2010cause mortality (OR 3.81, 95% CI 1.04\u221213.99).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our analysis demonstrates that the majority of patients treated with IVB for ISR derive sustained clinical benefit at 1 year. The association between stent implantation and long\u2010term mortality warrants further investigation. These findings highlight the importance of identifying novel predictors of treatment response to optimize patient selection for IVB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70139","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T04:29:22Z","timestamp":1757996962000},"page":"3239-3247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes of Intravascular Brachytherapy for Recurrent In\u2010Stent Restenosis: Is Treatment Failure Predictable?"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0383-6471","authenticated-orcid":false,"given":"Gal","family":"Sella","sequence":"first","affiliation":[{"name":"The Heart Center Kaplan Medical Center Affiliated With the Hebrew University of Jerusalem Rehovot Israel"},{"name":"Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chloe","family":"Kharsa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mangesh","family":"Kritya","sequence":"additional","affiliation":[{"name":"Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devin","family":"Olek","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Houston Methodist Hospital Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin S.","family":"Teh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Houston Methodist Hospital Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yueh\u2010Yun","family":"Lin","sequence":"additional","affiliation":[{"name":"Center for Health Data Science and Analytics Houston Methodist Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anshuj","family":"Deva","sequence":"additional","affiliation":[{"name":"Center for Health Data Science and Analytics Houston Methodist Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Faraz","family":"Anwaar","sequence":"additional","affiliation":[{"name":"Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Elias","sequence":"additional","affiliation":[{"name":"Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elia","family":"El Hajj","sequence":"additional","affiliation":[{"name":"Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9857-0519","authenticated-orcid":false,"given":"Albert E.","family":"Raizner","sequence":"additional","affiliation":[{"name":"Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Farach","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Houston Methodist Hospital Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4334-8133","authenticated-orcid":false,"given":"Neal S.","family":"Kleiman","sequence":"additional","affiliation":[{"name":"Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8600-6352","authenticated-orcid":false,"given":"Alpesh","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas 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