title: Late coronary occlusion after intracoronary brachytherapy.
abstract: BACKGROUND
  Intracoronary brachytherapy appears to be a promising technology to prevent restenosis. Presently, limited data are available regarding the late safety of this therapeutic modality. The aim of the study was to determine the incidence of late (>1 month) thrombosis after PTCA and radiotherapy.
  
  
  RESULTS
  From April 1997 to March 1999, we successfully treated 108 patients with PTCA followed by intracoronary beta-radiation. Ninety-one patients have completed at least 2 months of clinical follow-up. Of these patients, 6.6% (6 patients) presented with sudden thrombotic events confirmed by angiography 2 to 15 months after intervention (2 balloon angioplasty and 4 stent). Some factors (overlapping stents, unhealed dissection) may have triggered the thrombosis process, but the timing of the event is extremely unusual. Therefore, the effect of radiation on delaying the healing process and maintaining a thrombogenic coronary surface is proposed as the most plausible mechanism to explain such late events.
  
  
  CONCLUSIONS
  Late and sudden thrombosis after PTCA followed by intracoronary radiotherapy is a new phenomenon in interventional cardiology.
authors.affiliation: Thoraxcenter, Dijkzigt University Hospital, Rotterdam, The Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: Costa
authors.forename: M
authors.initials: M
authors.lastname: Sabaté
authors.forename: W J
authors.initials: WJ
authors.lastname: van der Giessen
authors.forename: I P
authors.initials: IP
authors.lastname: Kay
authors.forename: P
authors.initials: P
authors.lastname: Cervinka
authors.forename: J M
authors.initials: JM
authors.lastname: Ligthart
authors.forename: P
authors.initials: P
authors.lastname: Serrano
authors.forename: V L
authors.initials: VL
authors.lastname: Coen
authors.forename: P C
authors.initials: PC
authors.lastname: Levendag
authors.forename: P W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D003327:Coronary Disease / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015607:Stents