The role of brachytherapy and Cutting Balloon angioplasty in the current treatment of stent restenosis.
The Gamma I, START and INHIBIT trials conclusively demonstrate the feasibility, safety and efficacy of intracoronary radiation as the treatment of choice for stent restenosis. Further reports confirm this finding and extend the indications. Vascular brachytherapy should be made available for all patients with diffuse stent restenosis. Specific devices such as cutting balloons may improve the procedure but does not seem to have an impact alone on the evolution.
Bonan
Raoul
R
Institut de Cardiologie de Montréal, Quebec, Canada. raoul.bonan@mmic.net
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D001610:Beta Particles / Q000627:therapeutic use; D001918:Brachytherapy / Q000379:methods*; D023903:Coronary Restenosis / Q000209:etiology / Q000532:radiotherapy / Q000628:therapy*; D005720:Gamma Rays / Q000627:therapeutic use; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000532:radiotherapy / Q000628:therapy; D006801:Humans; D019919:Prosthesis Implantation / Q000009:adverse effects; D012501:Saphenous Vein / Q000637:transplantation; D015607:Stents / Q000009:adverse effects*