Intracoronary brachytherapy
Phong Nguyen-Ho MD
The Methodist DeBakey Heart Center and Baylor College of Medicine, Houston, Texas
Search for more papers by this authorGrzegorz L. Kaluza MD, PhD
The Methodist DeBakey Heart Center and Baylor College of Medicine, Houston, Texas
Search for more papers by this authorPawel T. Zymek MD
The Methodist DeBakey Heart Center and Baylor College of Medicine, Houston, Texas
Search for more papers by this authorCorresponding Author
Albert E. Raizner MD
The Methodist DeBakey Heart Center and Baylor College of Medicine, Houston, Texas
The Methodist DeBakey Heart Center, 6535 Fannin, Room FB 1034, Houston, TX 77030Search for more papers by this authorPhong Nguyen-Ho MD
The Methodist DeBakey Heart Center and Baylor College of Medicine, Houston, Texas
Search for more papers by this authorGrzegorz L. Kaluza MD, PhD
The Methodist DeBakey Heart Center and Baylor College of Medicine, Houston, Texas
Search for more papers by this authorPawel T. Zymek MD
The Methodist DeBakey Heart Center and Baylor College of Medicine, Houston, Texas
Search for more papers by this authorCorresponding Author
Albert E. Raizner MD
The Methodist DeBakey Heart Center and Baylor College of Medicine, Houston, Texas
The Methodist DeBakey Heart Center, 6535 Fannin, Room FB 1034, Houston, TX 77030Search for more papers by this authorAbstract
Patients presenting with in-stent restenosis have an increased risk of need for repeat intervention. Intracoronary brachytherapy is indicated for these patients to prevent recurrent in-stent restenosis. Three intravascular brachytherapy systems are currently FDA-approved for use in patients: one utilizing gamma-radiation (Cordis) and two using beta-radiation (Novoste and Guidant). Current evidence and labeling do not support using intracoronary brachytherapy for prevention of restenosis in de novo lesions. Brachytherapy is absolutely contraindicated in patients unable to take prolonged combination antiplatelet drugs. Aspirin and a thienopyridine should be taken for 6 months if no new stent is placed and 12 months if a new stent is placed. If possible, new stent implementation should be avoided. Cathet Cardiovasc Intervent 2002;56:281–288. © 2002 Wiley-Liss, Inc.
REFERENCES
- 1 Mehran R, Dangas G, Abizaid AS, Mintz GS, Lansky AJ, Satler LF, Pichard AD, Kent KM, Stone GW, Leon MB. Angiographic patterns of in-stent restenosis: classification and implications for long-term outcome. Circulation 1999; 100: 1872–1878.
- 2 Sabate M, Serruys PW, van der Giessen WJ, Ligthart JM, Coen VL, Kay IP, Gijzel AL, Wardeh AJ, den Boer A, Levendag PC. Geometric vascular remodeling after balloon angioplasty and beta- radiation therapy: a three-dimensional intravascular ultrasound study. Circulation 1999; 100: 1182–1188.
- 3 Weinberger J. Radiation. In: EJ Topol, editor. Textbook of interventional cardiology. Philadelphia, PA: W.B. Saunders; 1999. p 650–663.
- 4 Wilcox JN, Waksman R, King SB, Scott NA. The role of the adventitia in the arterial response to angioplasty: the effect of intravascular radiation. Int J Radiat Oncol Biol Phys 1996; 36: 789–796.
- 5 Scott NA, Cipolla GD, Ross CE, Dunn B, Martin FH, Simonet L, Wilcox JN. Identification of a potential role for the adventitia in vascular lesion formation after balloon overstretch injury of porcine coronary arteries. Circulation 1996; 93: 2178–2187.
- 6 Rubin P, Williams JP, Riggs PN, Bartos S, Sarac T, Pomerantz R, Castano J, Schell M, Green RM. Cellular and molecular mechanisms of radiation inhibition of restenosis: I, role of the macrophage and platelet-derived growth factor. Int J Radiat Oncol Biol Phys 1998; 40: 929–941.
- 7 De Leon H, Ollerenshaw JD, Griendling KK, Wilcox JN. Adventitial cells do not contribute to neointimal mass after balloon angioplasty of the rat common carotid artery. Circulation 2001; 104: 1591–1593.
- 8 Kaluza GL, Mazur W, Raizner AE. Basic science review: radiotherapy for prevention of restenosis. Cathet Cardiovasc Intervent 2001; 52: 518–529.
- 9 Teirstein PS, Kuntz RE. New frontiers in interventional cardiology: intravascular radiation to prevent restenosis. Circulation 2001; 104: 2620–2626.
- 10 Popowski Y, Verin V. Debate: centering is important. J Intervent Cardiol 1999; 12: 243–245.
- 11 Raizner AE. The centring debate: the importance of centring in endovascular brachytherapy. Vasc Radiother Monitor 1999; 2: 3–10.
- 12 Albiero R, Nishida T, Adamian M, Amato A, Vaghetti M, Corvaja N, Di Mario C, Colombo A. Edge restenosis after implantation of high activity (32)P radioactive beta-emitting stents. Circulation 2000; 101: 2454–2457.
- 13 Albiero R, Colombo A. European high-activity 32P radioactive stent experience. J Invas Cardiol 2000; 12: 416–421.
- 14 Kay IP, Wardeh AJ, Kozuma K, Foley DP, Knook AH, Thury A, Sianos G, van der Giessen WJ, Levendag PC, Serruys PW. Radioactive stents delay but do not prevent in-stent neointimal hyperplasia. Circulation 2001; 103: 14–17.
- 15 Teirstein PS, Massullo V, Jani S, Popma JJ, Mintz GS, Russo RJ, Schatz RA, Guarneri EM, Steuterman S, Morris NB, Leon MB, Tripuraneni P. Catheter-based radiotherapy to inhibit restenosis after coronary stenting. N Engl J Med 1997; 336: 1697–1703.
- 16 Teirstein PS, Massullo V, Jani S, Popma JJ, Russo RJ, Schatz RA, Guarneri EM, Steuterman S, Sirkin K, Cloutier DA, Leon MB, Tripuraneni P. Three-year clinical and angiographic follow-up after intracoronary radiation: results of a randomized clinical trial. Circulation 2000; 101: 360–365.
- 17 Waksman R, White RL, Chan RC, Bass BG, Geirlach L, Mintz GS, Satler LF, Mehran R, Serruys PW, Lansky AJ, Fitzgerald P, Bhargava B, Kent KM, Pichard AD, Leon MB. Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis. Circulation 2000; 101: 2165–2171.
- 18 Leon MB, Teirstein PS, Moses JW, Tripuraneni P, Lansky AJ, Jani S, Wong SC, Fish D, Ellis S, Holmes DR, Kerieakes D, Kuntz RE. Localized intracoronary gamma-radiation therapy to inhibit the recurrence of restenosis after stenting. N Engl J Med 2001; 344: 250–256.
- 19 Raizner AE, Oesterle SN, Waksman R, Serruys PW, Colombo A, Lim YL, Yeung AC, van der Giessen WJ, Vandertie L, Chiu JK, White LR, Fitzgerald PJ, Kaluza GL, Ali NM. Inhibition of restenosis with beta-emitting radiotherapy: report of the Proliferation Reduction with Vascular Energy trial (PREVENT). Circulation 2000; 102: 951–958.
- 20 Waksman R, Raizner AE, Yeung AC, Lanksy AJ, Vandertie L. Use of localized intracoronary beta radiation in treatment of in-stent restenosis: the INHIBIT randomized controlled trial. Lancet 2002; 359: 551–557.
- 21 Popma JJ, Suntharalingam M, Lansky AJ, Heuser RR, Speiser B, Teirstein PS, Massullo V, Bass T, Henderson R, Silber S, von Rottkay P, Bonan R, Ho KHK, Kuntz RE. A randomized trial of 90Strontium/90Yttrium beta radiation versus placebo for the treatment of in-stent restenosis. Circulation 2002 (in press).
- 22 Costa MA, Sabate M, van der Giessen WJ, Kay IP, Cervinka P, Ligthart JM, Serrano P, Coen VL, Levendag PC, Serruys PW. Late coronary occlusion after intracoronary brachytherapy. Circulation 1999; 100: 789–792.
- 23 Waksman R, Bhargava B, Mintz GS, Mehran R, Lansky AJ, Satler LF, Pichard AD, Kent KM, Leon MB. Late total occlusion after intracoronary brachytherapy for patients with in-stent restenosis. J Am Coll Cardiol 2000; 36: 65–68.
- 24 Teirstein PS, Moses JW, Casterella PJ, Leon MB, Giap H, Koka A, Huppe GB, Sirkin K, Jani S, Grise M, Batler S, Tripuraneni P, Lansky AJ, Mehran R. Late thrombosis after coronary radiation may be eliminated by longer antiplatelet therapy and reduced stenting: the SCRIPPS III results. J Am Coll Cardiol 2001; 37( Suppl A): 1221–1229.
- 25 Waksman R, Ajani AE, White RL, Pinnow E, Dieble R, Bui AB, Taaffe M, Gruberg L, Mintz GS, Satler LF, Pichard AD, Kent KK, Lindsay J. Prolonged antiplatelet therapy to prevent late thrombosis after intracoronary gamma-radiation in patients with in-stent restenosis: Washington Radiation for In-Stent Restenosis Trial Plus 6 Months of Clopidogrel (WRIST PLUS). Circulation 2001; 103: 2332–2335.
- 26 Sabate M, Costa MA, Kozuma K, Kay IP, van der Giessen WJ, Coen VL, Ligthart JM, Serrano P, Levendag PC, Serruys PW. Geographic miss: a cause of treatment failure in radio-oncology applied to intracoronary radiation therapy. Circulation 2000; 101: 2467–2471.
- 27 Kim HS, Waksman R, Cottin Y, Kollum M, Bhargava B, Mehran R, Chan RC, Mintz GS. Edge stenosis and geographical miss following intracoronary gamma radiation therapy for in-stent restenosis. J Am Coll Cardiol 2001; 37: 1026–1030.
- 28 Condado JA, Lansky AJ, Saucedo JF, Caldera C, Fadoul M, Gurdiel O, Waksman R. Five year clinical and angiographic follow-up after intracoronary 192-Iridium radiation therapy. Circulation 2000; 102( Suppl II): II750.
- 29 Vandergoten P, Brosens M, Benit E. Images in cardiology: “late-late” reocclusion after coronary stenting and brachytherapy. Heart 2001; 85: 10.
- 30 Teirstein PS, Massullo V, Jani S, Popma JJ, Mintz GS, Russo RJ, Schatz RA, Guarneri EM, Steuterman S, Cloutier DA, Leon MB, Tripuraneni P. A subgroup analysis of the Scripps Coronary Radiation to Inhibit Proliferation Poststenting trial. Int J Radiat Oncol Biol Phys 1998; 42: 1097–1104.
- 31 Laskey WK, Heuser RR, Suntharalingam M, Bass TA, Silber S, Rutherford BD, Wilmer C, Berke AD, Snell RJ, Popma JJ, Kuntz RE. Effects of 90Sr/90Y beta radiation on diabetic patients with in-stent restenosis. Circulation 2000; 102; II668.
- 32 Sousa JE, Costa MA, Abizaid A, Abizaid AS, Feres F, Pinto IM, Seixas AC, Staico R, Mattos LA, Sousa AG, Falotico R, Jaeger J, Popma JJ, Serruys PW. Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries: a quantitative coronary angiography and three-dimensional intravascular ultrasound study. Circulation 2001; 103: 192–195.
- 33 Sousa JE, Costa MA, Abizaid AC, Rensing BJ, Abizaid AS, Tanajura LF, Kozuma K, Van Langenhove G, Sousa AG, Falotico R, Jaeger J, Popma JJ, Serruys PW. Sustained suppression of neointimal proliferation by sirolimus-eluting stents: one-year angiographic and intravascular ultrasound follow-up. Circulation 2001; 104: 2007–2011.