Condado J A
Centro Medico Caracas, Venezuela.
Semin Interv Cardiol. 1997 Jun;2(2):115-8.
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.
再狭窄是所有血管重建手术充分扩张的主要限制因素。弹性线圈、不良重塑以及对损伤的增殖反应是再狭窄更为重要的机制。基于对细胞增殖抑制作用的电离辐射已广泛应用于多种肿瘤和非肿瘤疾病的治疗。实验性近距离放射治疗已证明可在动物模型中减少外周动脉和冠状动脉的再狭窄，γ射线放射治疗可降低患者股腘动脉支架植入术后的再狭窄。我们制定了一项方案来评估冠状动脉成形术后γ冠状动脉内放射治疗的可行性、安全性和效果，并使用了直径为0.018英寸和0.014英寸、有效长度为30毫米的导线，将192铱放入封闭通道的聚乙烯导管中，源未在血管壁内居中。我们给21例患者的参考动脉直径规定了25 Gy和20 Gy的剂量。24小时、两个月和六个月后的血管造影随访表明，冠状动脉内放射治疗是可行且安全的，初步分析指出晚期丢失有所减少。不同源和程序的疗效和安全性应得到充分确立。人们对血管内近距离放射治疗的疗效和安全性寄予厚望，以增加血管内再通手术的应用。
