Radiation vascular therapy: a novel approach to preventing restenosis.
In animal studies, beta and gamma radiation delivered via catheter-based systems to sites of angioplasty after arterial injury has decreased the neointimal proliferation that is a part of the restenotic process. Extending radiotherapy to the clinical setting, results of the double-blind, placebo-controlled, randomized Scripps Coronary Radiation to Inhibit Proliferation Post Stenting (SCRIPPS) study showed dramatic reductions in the rate of restenosis after coronary stenting when catheter-based gamma radiotherapy (with iridium-192) was used. In the Beta Energy Restenosis Trial (BERT), angiographic, intravascular ultrasound, and clinical outcomes were better than expected with beta brachytherapy. Strontium-90/yttrium-90 seeds were delivered via a unique catheter system in 35 patients who underwent coronary angioplasty. Future trials are being planned to confirm these promising results.
Williams
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Division of Cardiology, Rhode Island Hospital, Providence 02903, USA.
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D000818:Animals; D001918:Brachytherapy / Q000295:instrumentation*; D002455:Cell Division / Q000528:radiation effects; D003327:Coronary Disease / Q000532:radiotherapy*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome; D017539:Tunica Intima / Q000528:radiation effects