Increased dosage during intracoronary irradiation due to overlapped source stepping shows no long-term adverse
Bonni Syeda1, Nabil Yahya, Rainer Schmid
1Department of Internal Medicine II, Division of Cardiology, University of Vienna, Vienna, Austria. bonni.syeda@akh-wien.ac.at
Purpose:
The purpose of this analysis was to evaluate if overdosage during intracoronary irradiation due to overlapped source stepping may result in long-term morphologic changes in vessel anatomy.
Methods:
Baseline angiograms of patients with in-stent restenosis undergoing coronary reintervention followed by intracoronary irradiation with source stepping were analyzed. Overlapping was considered present for the segment with overlapped reference isodose length (RIL) (RIL = segment with > or = 90% of reference dose at 1 mm vessel wall depth). Baseline and 6-months follow-up volumetric intravascular ultrasound (IVUS) analysis were performed for the overlapped segment and for proximal and distal segments of equal length.
Results:
Overlapping was found in six patients (three patients: (32)P treatment; three patients: (90)Sr/Y treatment); final analysis was performed in four patients. Comparison of the baseline and follow-up IVUS volumetric parameters revealed no significant change in lumen or vessel volumes at segments of overlaps in comparison to proximal and distal reference segments.
Conclusion:
Increased dosage due to overlapping during source stepping is not associated with morphologic changes in vessel anatomy at follow-up.
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