[Brachytherapy for coronary restenosis: state of art in 2003].
Based on therapeutic approach for benign diseases, vascular brachytherapy decreases smooth vascular muscle cells proliferation and multiplication which lead to the formation of the neo-intima. The radioactive positive action affects arterial recoil due to post angioplasty vessel injury. Randomised studies has shown good angiographic results up to 6 months of follow-up, with 50% in-stent restenosis rate decrease and on the analysed segment as well. Decrease on Mace and TLR show statistically significance. Results don't correlate with emitter and bêta emitters had been introduced in France recently. Vascular brachytherapy is actually indicated for in-stent restenosis, there is no evidence to perform this treatment for de novo lesion. Geographic miss, source centering, late thrombosis and pullback procedure may interfere with treatment quality. IVUS allows best target volume determination to a higher quality level. Internationals guidelines such as Eva-Gec-Estro recommendations could increase treatment safety and enable development of an optimal technique.
Latorzeff
I
I
Département de radiothérapie, institut Claudius-Regaud, rue Pont-Saint-Pierre, 31052 cedex, Toulouse, France. muriel.latorzeff@worldonline.fr <muriel.latorzeff@worldonline.fr>
Carrie
D
D
Alibelli
M-J
MJ
Bonnet
J
J
Duthil
P
P
Delannes
M
M
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D001610:Beta Particles / Q000627:therapeutic use; D001918:Brachytherapy / Q000295:instrumentation / Q000706:statistics & numerical data; D002986:Clinical Trials as Topic; D020099:Coated Materials, Biocompatible; D023903:Coronary Restenosis / Q000503:physiopathology / Q000532:radiotherapy*; D005602:France; D005720:Gamma Rays; D006207:Half-Life; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D010761:Phosphorus Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000627:therapeutic use; D015607:Stents; D013326:Strontium Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use
D020099:Coated Materials, Biocompatible; D007496:Iridium Radioisotopes; D010761:Phosphorus Radioisotopes; D019275:Radiopharmaceuticals; D013326:Strontium Radioisotopes; D015021:Yttrium Radioisotopes