Intracoronary Beta‐Radiation Therapy for In‐stent Restenosis: Long‐Term Success Rate and Prediction of Failure

Vlachojannis, Georgios J.; Fichtlscherer, Stephan; Spyridopoulos, Ioakim; Auch-Schwelk, Wolfgang; Schopohl, B.; Zeiher, Andreas M.; Schächinger, Volker

doi:10.1111/j.1540-8183.2009.00522.x

Cited by 7 publications

(6 citation statements)

References 33 publications

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“…Adjunctive coronary brachytherapy was once the preferred therapy for in-stent restenosis to prevent recurrence in patients with BMS (8,9). However, long-term follow-up of intracoronary brachytherapy confirmed a risk of delayed stent failure, and hence, this approach is no longer used (3,4). In another study in pigs, coronary EBRT resulted in increased neointimal and adventitial collagen compared with intracoronary radiotherapy, and focal interstitial necrosis in the adjacent myocardium was only seen in the EBRT-treated pigs (15).…”

Section: Radiation Therapy As Treatment For Cadmentioning

confidence: 95%

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Outcomes After Percutaneous Coronary Intervention With Stents in Patients Treated With Thoracic External Beam Radiation for Cancer

Liang

Sio

Slusser

et al. 2014

JACC: Cardiovascular Interventions

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Section: Radiation Therapy As Treatment For Cadmentioning

confidence: 95%

“…However, long-term follow-up demonstrated a delayed risk of stent failure (3,4). This observation raises the possibility that EBRT may adversely affect outcomes in patients with coronary stents, but there is a paucity of data on the subject.…”

mentioning

confidence: 88%

Outcomes After Percutaneous Coronary Intervention With Stents in Patients Treated With Thoracic External Beam Radiation for Cancer

Liang

Sio

Slusser

et al. 2014

JACC: Cardiovascular Interventions

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“…The possibility of late restenosis after brachytherapy for ISR has been demonstrated in studies with longer follow-up (up to five years), frequently necessitating late TVR. 16,17 In our study, with a mean 10-year follow-up, the incidence of MACE was 16.6%. This figure is low considering the severity of the patients treated and the long followup period.…”

Section: Discussionmentioning

confidence: 46%

Late results (>10 years) of intracoronary beta brachytherapy for diffuse in-stent restenosis

Gomes

Gonçalves

Teles

et al. 2014

Revista Portuguesa de Cardiologia (English Edition)

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Introduction: Until the development of drug-eluting stents (DES), diffuse in-stent restenosis (ISR) was the main limitation of bare-metal stents in percutaneous coronary intervention (PCI). Among the different treatments available, intracoronary brachytherapy (BT) emerged as one of the most promising, although it was almost abandoned with the increasing use of DES. Objective: To assess the Portuguese experience with 90 Sr/ 90 Y beta brachytherapy for the treatment of diffuse ISR regarding long-term (>10 years) major adverse cardiac events (MACE) and angiographic restenosis. Methods: This single-center, retrospective, observational study included 12 consecutive patients treated between January and June 2001, mean age 58.6±9.9 years (range 43---77 years), 11 male. All had chronic stable angina, 75% had dyslipidemia, 58% had hypertension, 50% had peripheral arterial disease, 42% had diabetes and 50% had multivessel disease. Recurrent ISR was present in half of the patients and 11 had normal left ventricular function. After balloon dilatation, BT was performed using an 90 Sr/ 90 Y (Novoste Beta-Cath TM ) beta radiation source. All patients remained under dual antiplatelet therapy until scheduled nine-month follow-up angiography. Patients were followed for the occurrence of death (all-cause and cardiovascular), non-fatal myocardial infarction (MI), revascularization, stent thrombosis and angiographic restenosis. MACE were defined as the combined incidence of cardiac death, MI and urgent target vessel revascularization. Results: In all cases there was both clinical and angiographic success. In a mean follow-up of 10.9±2.5 years, 19 events occurred in seven patients: death in three (25%), only one cardiac ଝ Please cite this article as: Seabra Gomes R, de Araújo Gonçalves P, Campante Teles R, et al. Avaliação tardia (>10 anos) da braquiterapia intracoronária com radiação beta para reestenose difusa intrastent. Rev Port Cardiol. 2014;33:609---616.

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“…There is limited availability of long-term data regarding intracoronary beta-radiation treatment and considerable concern that intracoronary brachy therapy may only result in delaying the problem of in-stentrestenosis. The long-term clinical outcomes of patients treated with beta-radiation for in-stent restenosis [23].…”

Section: Applications Of Beta Radiationmentioning

confidence: 99%

Fundamental characteristics and application of radiation

Karmaker¹,

Maraz²,

Islam³

et al. 2021

GSC Adv. Res. Rev.

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Radiation is the emission or transmission of energy as waves or particles through space or through a material medium which is able to penetrate various materials and is often categorized as either ionizing or non-ionizing depending on the energy of the radiated particles. Radiation processing can be defined as exposure of materials with high energy radiation to change their physical, chemical, or biological characteristics, to increase their usefulness, and safety purpose, or to reduce their harmful impact on the environment. Ionizing radiation is produced by radioactive decay, nuclear fission, and fusion, by extremely hot objects, and by particle accelerators. The radiation coming from the sun is due to the nuclear fusion; therefore, we are living in a natural radioactive world. Radioactive substances are common sources of ionized radiation that emit α, β, or γ radiation, consisting of helium nuclei, electrons or positrons, and photons, respectively. Alpha rays are the weakest form of radiation and can be stopped by paper. Beta rays are able to pass through paper but not through aluminum. Gamma rays are the strongest radiation. They are able to pass through paper and aluminum, but not through a thick block of lead or concrete. Alpha and beta radiation are the high energy subatomic particles where gamma radiation is a form of high energy electromagnetic waves. This review presents the fundamental introduction of radiation, the three types of radiation, and their applications.

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Intracoronary Beta‐Radiation Therapy for In‐stent Restenosis: Long‐Term Success Rate and Prediction of Failure

Cited by 7 publications

References 33 publications

Outcomes After Percutaneous Coronary Intervention With Stents in Patients Treated With Thoracic External Beam Radiation for Cancer

Outcomes After Percutaneous Coronary Intervention With Stents in Patients Treated With Thoracic External Beam Radiation for Cancer

Late results (>10 years) of intracoronary beta brachytherapy for diffuse in-stent restenosis

Fundamental characteristics and application of radiation

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