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Complex transradial three vessel brachytherapy in a single session
Olivier F Bertrand1, Robert De Larochelliere, Michel Tessier
1Interventional Cardiology Laboratories, Quebec Heart-Lung Institute/Laval Hospital, 2725, chemin Ste-Foy, Quebec City, Quebec, Canada, G1V 4G5. ofbertrand@videotron.ca
Insights
Multivessel brachytherapy via the transradial approach is feasible in a single session for treating coronary in-stent restenosis. This innovative technique successfully restored blood flow without requiring additional stenting.
Area of Science:
- Interventional Cardiology
- Radiation Oncology
Background:
- Coronary artery disease often requires interventions like stenting.
- In-stent restenosis (ISR) remains a challenge after coronary stenting.
- Transradial access offers an alternative approach for cardiac interventions.
Observation:
- A patient presented with unstable angina and severe, diffuse in-stent restenosis in the LAD, Cx, and Mg arteries.
- The patient underwent successful balloon angioplasty of the affected coronary vessels.
- Vascular brachytherapy was performed using the Novoste Beta-Rail system with 90Sr/Y radioactive seeds.
Findings:
- Transradial multivessel brachytherapy was successfully completed in a single session.
- No additional stenting was required post-brachytherapy.
- Follow-up angiography demonstrated widely patent vessels with no evidence of restenosis.
Implications:
- Transradial multivessel brachytherapy is a viable option for managing complex in-stent restenosis.
- This approach may reduce the need for repeat stenting and associated complications.
- Further research can explore the long-term efficacy and safety of this technique.
Background:
We report the case of a patient who underwent transradial brachytherapy in 3 different coronary vessels during a single session. She initially presented with unstable angina 4 months after the index procedure; control angiography showed severe and diffuse in-stent restenosis in the LAD, Cx and Mg arteries.
Methods:
After successful dilatation of the three vessels, we performed vascular brachytherapy using the Novoste Beta-Rail system and a 60 mm length source train of 90Sr/Y radioactive seeds. No further stent was implanted. The patient left the hospital the next day. Follow-up angiography revealed widely patent vessels with no restenosis.
Conclusion:
Transradial multivessel brachytherapy can be done during the same session.
