title: Clinical and angiographic outcomes of cardiac transplant patients treated with intracoronary beta-radiation for in-stent restenosis: a case series.
abstract: BACKGROUND
  Vascular brachytherapy (VBT) is effective for the treatment of in-stent restenosis (ISR), however, the effect of VBT clinical and angiographic outcomes of patients with ISR who have undergone orthotopic heart transplantation (OHT) requires further study.
  
  
  METHODS
  All OHT patients with ISR treated with VBT using the Novoste Beta-Cath System at Rush University Medical Center were identified, and the clinical and angiographic outcomes were evaluated.
  
  
  RESULTS
  Four OHT patients with ISR who underwent VBT were identified. The mean age was 48.5 years, and the mean duration posttransplantation was 7.5 years. The mean reference coronary vessel diameter was 3.06 mm. The primary interventional device utilized prior to VBT was cutting balloon angioplasty (CBA) in 75% and percutaneous balloon angioplasty in 25%. The mean duration of follow-up after VBT was 11 months. There were no deaths attributable due to cardiac disease, no myocardial infarction, and no target vessel revascularization on follow-up. Overall survival during this period was 75%, with one mortality due to stroke 8 months after VBT.
  
  
  CONCLUSIONS
  VBT for the treatment of ISR in patients who have undergone OHT appears safe and feasible and is associated with acceptable clinical and angiographic outcomes.
authors.affiliation: Rush University Medical Center, Rush Heart Institute and Rush Medical College, Chicago, IL, USA. falmeda@aol.com
authors.forename: Francis Q
authors.initials: FQ
authors.lastname: Almeda
authors.forename: Rajesh
authors.initials: R
authors.lastname: Nambiar
authors.forename: Dave C Y
authors.initials: DC
authors.lastname: Chua
authors.forename: Shaun
authors.initials: S
authors.lastname: Senter
authors.forename: Justin
authors.initials: J
authors.lastname: Haynie
authors.forename: Clifford J
authors.initials: CJ
authors.lastname: Kavinsky
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Snell
authors.forename: Cam
authors.initials: C
authors.lastname: Nguyen
authors.forename: James C H
authors.initials: JC
authors.lastname: Chu
authors.forename: Gary L
authors.initials: GL
authors.lastname: Schaer
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D001918:Brachytherapy; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000628:therapy*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome