[Effect of beta radiation brachytherapy in the treatment of restenosis of coronary stents].
Brachytherapy currently represents the only treatment method for in-stent restenosis (ISR) confirmed in randomised clinical studies. In a group of 46 patients, selected for brachytheraphy on the bases of clinical signs of restenosis accompanied with development or deterioration of angina pectoris and with angiography results showing significant in-stent restenosis, we used a beta radiation system BetaCath NOVOSTE. This therapy was safe. Results of acute angiography were positive in 91% of patients. Clinical restenoses within 6 month of clinical monitoring occurred in 8.6% of patients. Due to impairment of more arteries in the majority of patients from the sample, following revascularisation of nontarget vessels was necessary in 19.6% of patients. We haven't observed late thrombosis. It was probably eliminated by prolonged administration of a combination of aspirin and clopidogrel. Dosimetry results during brachytherapy showed that doses of radiation both for a surgeon and a patient corresponded to a fraction of doses received from an x-ray apparatus during fluoroscopy and acquisition. Both an edge restenosis and a diffuse restenosis were identified in stenoses of patients with in-stent restenosis. Brachytherapy with beta radiation seems to be an efficient method for treatment of coronary in-stent restenosis.
Kovác
J
J
Kardiologická klinika Univerzitní Glenfieldské vseobecné nemocnice, Leicester, Anglie.
Lukl
J
J
Gershlick
A
A
D015906:Angioplasty, Balloon, Coronary; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation; D023903:Coronary Restenosis / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D015607:Stents