Vascular brachytherapy in renal artery restenosis.
OBJECTIVE
As renal artery stenting becomes more commonly performed, the prevalence of renal artery in-stent restenosis will increase. Intracoronary brachytherapy is the only adjuvant therapy that has been shown to reduce the incidence of recurrent restenosis. This review addresses the mechanisms that make brachytherapy an effective tool for restenosis and its application to renal arteries.


RESULTS
To date, the literature on renal artery brachytherapy for restenosis consists of several singular case reports and two case series. The first series of 13 patients had a 20% restenosis rate 1 year after brachytherapy, when Doppler ultrasound was used for follow-up monitoring. A report of a series of 5 patients, published this year, used surrogate markers for assessing efficacy as endpoints and found a similar restenosis rate.


CONCLUSIONS
These series and case reports demonstrate that renal brachytherapy is feasible and safe. Comments on efficacy must await a randomized trial or accumulation of more anecdotal data.
Reilly
John P
JP
Cardiac Catheterization Laboratory, Ochsner Clinic, New Orleans, Louisiana 70121, USA. jreilly@ochsner.org
Ramee
Steven R
SR
D001918:Brachytherapy / Q000379:methods*; D006801:Humans; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000628:therapy*; D016896:Treatment Outcome