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  Česky / Czech version Vnitř. Lék., 50, 2004, No. 2, p. 112 - 117
 
An effect of Brachytherapy with Beta Radiation in Treatment of Coronary In-stent Restenosis 
Kováč J.1, Lukl J.2, Gershlick A.1  

1Kardiologická klinika Univerzitní Glenfieldské všeobecné nemocnice, Leicester, Anglie 2I. interní klinika Lékařské fakulty UP a FN, Olomouc, přednosta prof. MUDr. Jan Lukl, CSc.
 


Summary:

       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 brachyteraphy 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.

        Key words: Stent - Restenosis - Brachytherapy
       

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