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Coronary Artery Disease: HELP
Articles by Jacob R. Gallagher
Based on 1 article published since 2008
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Between 2008 and 2019, Jacob R. Gallagher wrote the following article about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Article Usefulness of Intracoronary Brachytherapy for Patients With Resistant Drug-Eluting Stent Restenosis. 2017

Mangione, Fernanda M / Jatene, Tannas / Badr Eslam, Roza / Bergmark, Brian A / Gallagher, Jacob R / Shah, Pinak B / Mauri, Laura / Leopold, Jane A / Sobieszczyk, Piotr S / Faxon, David P / Croce, Kevin J / Bhatt, Deepak L / Devlin, Phillip M. ·Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts; Beneficência Portuguesa de São Paulo Hospital, São Paulo, Brazil. · Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts. · Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. · Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts. Electronic address: dlbhattmd@post.harvard.edu. ·Am J Cardiol · Pubmed #28583681.

ABSTRACT: In-stent restenosis (ISR) remains a concern even in the drug-eluting stent (DES) era and carries a high risk of recurrence. Brachytherapy is being used as an alternative treatment for resistant ISR, yet the safety and efficacy of this approach has not been well studied. We analyzed the outcomes of 101 patients who underwent coronary brachytherapy for resistant DES ISR. Baseline demographic, clinical, procedural, and outcome data were collected by phone and from electronic records. Comorbidities and overt cardiovascular disease were highly prevalent. Median previous stent layers were 2 with a maximum of 5 layers. Procedural angiographic success rate was 97% and median time to discharge was 1 day after brachytherapy. The primary outcome of target vessel revascularization was 24% at 1 year, 32% at 2 years, and 42% at 3 years. The rate of nonfatal myocardial infarction was 0% at 1 year, 3.5% at 2 years, and 6% at 3 years. The rate of all-cause mortality was 8.5% at 1 year, 12% at 2 years, and 16% at 3 years. We observed only 1 case of late stent thrombosis. After multivariable adjustment, female gender (hazard ratio 2.37, 95% confidence interval 1.02 to 5.52, p = 0.04) and diffuse ISR pattern (hazard ratio 2.95, 95% confidence interval 1.21 to 7.17, p = 0.01) were independently associated with the primary outcome. In conclusion, brachytherapy is feasible for the treatment of resistant DES ISR and is associated with high immediate procedural success and reasonable efficacy in a complex patient population. This approach might be used as an alternative for these patients.