Beta brachytherapy of an old degenerated saphenous vein graft with occlusive in-stent restenosis.
We report a case of obstructive in-stent restenosis in a diffusely diseased saphenous vein graft complicated by a non-ST-elevation myocardial infarction. With tirofiban infusion, the extensively occluded saphenous bypass was reperfused, establishing a TIMI flow 3, and then entirely irradiated with a beta source (32P) without any complication. At 7 months the patient was asymptomatic and the control angiogram did not reveal any restenosis. In conclusion, 32P beta brachytherapy may be extremely effective not only in case of native vessel in-stent restenosis but also in cases of high-risk vein graft in-stent restenosis.
Ortolani
Paolo
P
Institute of Cardiology, University of Bologna, Bologna, Italy. paortol@tin.it
Marzocchi
Antonio
A
Gaiba
William
W
Neri
Stefano
S
Marrozzini
Cinzia
C
Palmerini
Tullio
T
Aquilina
Matteo
M
Branzi
Angelo
A
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000627:therapeutic use; D001610:Beta Particles / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis; D001918:Brachytherapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000532:radiotherapy*; D006801:Humans; D009203:Myocardial Infarction / Q000532:radiotherapy / Q000628:therapy; D010761:Phosphorus Radioisotopes / Q000627:therapeutic use; D012086:Reoperation; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000528:radiation effects* / Q000637:transplantation*; D015607:Stents / Q000009:adverse effects*; D013988:Ticlopidine / Q000627:therapeutic use; D000077466:Tirofiban; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010761:Phosphorus Radioisotopes; D014443:Tyrosine; D000077466:Tirofiban; D013988:Ticlopidine; D001241:Aspirin