Slides
Repeat Brachytherapy for Late Restenosis after Intracoronary Brachytherapy
- Operator : Bon-Kwon Koo
| Repeat Brachytherapy for Late Restenosis after Intracoronary Brachytherapy |
| - Operator : Bon-Kwon Koo, MD, PhD / Myoung-Mook Lee, MD, PhD, Korea |
| A 54-year old male patient was admitted due to exertional
chest pain for 2 months. His risk factors were smoking and hypertension.
One year ago, the patient had received brachytherapy with a 188-rhenium-DTPA-filled
balloon catheter system (17.6 Gy at 1 mm depth) after balloon angioplasty
for a de novo proximal RCA lesion (Figure
1). The irradiated lesion had been patent at 6-month follow-up angiogram
after brachytherapy (Figure
2). One-year follow-up coronary angiography showed a tight restenosis of previous irradiated lesion (Figure 3). There was no significant luminal narrowing at left coronary artery. After balloon angioplasty (2.5 X 15 mm balloon) for this restenotic lesion, type C dissection and significant residual stenosis were observed. Therefore, stent (Tetra, 3 X 18 mm, Guidant) implantation followed by the 2nd brachytherapy was performed. Irradiation was performed with a 188-rhenium-DTPA-filled angioplasty balloon (VIVA, 3 x 30 mm, Boston) (Figure 4) with identical method and dosage as the 1st radiation therapy. Two-year follow-up angiogram after the 2nd brachytherapy showed patent irradiated segment (Figure 5). Up to now (35 months after the 2nd VBT), the patient is still in chest pain free state. |
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