What is Coronary Brachytherapy?
Coronary brachytherapy is a special procedure using radiation therapy inside a stent to prevent recurrent blockage (restenosis).
What is restenosis?
Patients who have a blocked artery in the heart have a stent placed to open the blockage. These stents (called drug-coated stents) have a medication on the stent to limit scar tissue that grows inside the stent. Although these stents are very effective, some patients develop re-narrowing of the stent caused by excessive scar tissue; this process is called restenosis.
Treatment of restenosis
The most common treatment of restenosis is placement of another drug-coated stent inside the old stent, since this usually works better than balloon alone. If a patient develops restenosis after two or more layers of stents, radiation treatment (brachytherapy) is an excellent option for preventing another recurrence of blockage due to scar tissue.
How does brachytherapy work?
Unlike the way radiation is used to destroy cancer cells, brachytherapy inside the artery does not destroy cells in the scar tissue that narrows the artery. Instead, a balloon is usually used to open the narrowing as much as possible, and then radiation is used to prevent cells that cause scar tissue from rapidly dividing, leading to another blockage. Radiation treatment is the best method for preventing recurrent blockage after multiple stents.
How is coronary brachytherapy given?
First, the interventional cardiologist opens the scar tissue as much as possible with a balloon (angioplasty). Next a thin ribbon is advanced inside the artery to deliver radiation to the vessel wall. After three to five minutes, the radiation is withdrawn and the procedure is completed. Adding another stent is possible, but usually not necessary. This type of radiation does not affect the rest of the body. The procedure can be performed from either the artery in the wrist or groin.
What to expect after coronary brachytherapy?
There is no pain associated with brachytherapy. The recovery after brachytherapy is like a heart catheterization. You will need a few days to rest and limit physical activity.
How effective is coronary brachytherapy?
Brachytherapy greatly reduces the chance of recurrent blockages and need for repeat heart catheterization procedures.
Is coronary brachytherapy right for you?
The decision to perform coronary brachytherapy will be made by your primary cardiologist and must be customized to each patient. For patients with multiple episodes of restenosis we believe this is an excellent treatment option.