Basis of endovascular radiation therapy in human coronary arteries.

Restenosis is the major limitation to a full expansion of all revascularization procedures. Elastic coil, unfavorable remodeling and a proliferative response to injury are the more importune mechanisms to restenosis. Ionizing radiation based on the inhibitory effect on cellular proliferation has been widely used in the treatment of numerous neoplastic and non neoplastic conditions. Experimental brachytherapy has demonstrated to reduce restenosis in peripheral arteries and coronary arteries in animal models and gamma-radiation therapy decrease restenosis after stent implantation in femoral-popliteal arteries in patients. We developed to evaluate the feasibility, safety and effects of gamma intracoronary radiation therapy after coronary angioplasty a protocol and used a wire 0.018 and 0.014 inches in diameter and 30 mm active length with 192 Iridium into the closed channel polyethylene catheter was not centered the source within the vessel wall. We prescribed 25 Gy and 20 Gy to the diameter of the reference artery to 21 patients. The 24 hours, two months and after six months angiographic follow up demonstrated that intracoronary radiation therapy was feasible and safe and preliminary analysis point out a reduction in late loss. The efficacy and safety of the different sources and procedures should be well established. There is a great expectation regarding the efficacy and safety of vascular brachytherapy to increasing the use of endovascular recanalization procedures.