Intracoronary radiotherapy for prevention of restenosis after percutaneous coronary interventions.

Abstract:

:More than 50 different pharmacological and mechanical interventions have been tested to date for prevention of vascular restenosis without success. Intracoronary radiotherapy is the first one showing promise of significantly attenuating neointimal proliferation, causing positive vascular remodelling and thus inhibiting restenosis. This promising modality has moved from animal experiments via safety and feasibility testing into the phase of clinical trials of efficacy in large numbers of patients. While ongoing research continues to search for new sources and delivery techniques, currently available technology is being optimized. The randomized clinical trials conducted to date have shown consistently a reduction of target site restenosis rates by 55-79%. Lower incidence of major adverse cardiac events after radiotherapy has also been demonstrated, primarily as a result of reduction in target site and target vessel revascularization rates. However, experimental and clinical research has identified two major complications of this approach: stenosis at the ends of the radiation zone ('edge effect' or 'candywrapper') as well as late thrombosis (beyond 30 days after intervention) of the angioplasty or stent site. If these two adverse effects can be minimized, intracoronary radiotherapy may prove to be a major breakthrough in percutaneous coronary interventions.

journal_name

Ann Med

journal_title

Annals of medicine

authors

Kaluza GL,Ali NM,Raizner AE

doi

10.3109/07853890009002033

subject

Has Abstract

pub_date

2000-12-01 00:00:00

pages

622-31

issue

9

eissn

0785-3890

issn

1365-2060

journal_volume

32

pub_type

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