Monte carlo parametric study of stent impact on dose for catheter-based intravascular brachytherapy with 90Sr/90Y

The radiation treatment of catheter-based beta-emitter sources is being used to prevent restenosis following interventional coronary procedures. We present the results of a Monte Carlo calculation study to assess the dosimetric impact in the vessel tissue due to the presence of the stent. A catheter-based beta-emitter system is modeled using the Monte-Carlo code MCNP4B. Dose distributions are calculated in annular voxels (0.050 x 0.025 mm2 section) along the axis of a 40 mm. 90Sr/90Y source with and without the stent (at a distance of 1.5-3.0 mm from the longitudinal axis of the source). The main results include: (a) a clear difference between the local perturbation just behind the strut and a more general perturbation seen deeper into the vessel tissue; (b) the local perturbations disappears at a depth of 300-400 microm while the more general perturbation affects the tissue in its full thickness including the prescription point; (c) in the local perturbation the maximum impact is determined mainly by the material and the thickness of the strut while the spatial attenuation of this impact is defined mainly by the strut width; (d) in the general perturbation, the most important magnitude is the free-area ratio for the path of the electrons, being the material characteristics and strut thickness of secondary importance; (e) analytical expressions are presented to estimate the magnitude of this perturbation according to the complete characteristics of the expanded strut, i.e., thickness, free-area ratio, and material; and (f) a simple algorithm is presented for estimating the free-area ratio when this information is not available.