CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
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. |
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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.
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