Secondary revascularisation following intracoronary brachytherapy

Intracoronary brachytherapy (ICB) was developed as an attempt to prevent restenosis after percutaneous coronary interventions. Early clinical experiences showed impressive results especially in the subset of patients with in-stent restenosis. This led to the design of large multicentre trials that demonstrated the efficacy of ICB as adjunctive therapy in patients with in-stent restenosis as compared to conventional treatment. Despite these outstanding initial results, several limitations arose such as late thrombosis, edge effect or late catch-up phenomenon. These, together with the difficult logistic process to implement the ICB in the cath lab and the development of the drug-eluting stent shelved definitely the technique. This review describes the potentials and limitations of this therapy, as well as the current status in the drug-eluting stent era.