Intracoronary beta-radiation after percutaneous transluminal coronary angioplasty was associated with a 6.6% incidence of late and sudden thrombosis occurring 2 to 15 months post-intervention.
Observational (n=108)
Does PTCA followed by intracoronary beta-radiation lead to late thrombosis in patients undergoing coronary intervention?
Intracoronary beta-radiation after PTCA is associated with a 6.6% incidence of late, sudden coronary thrombosis, likely due to delayed healing of the coronary surface.
BACKGROUND: Intracoronary brachytherapy appears to be a promising technology to prevent restenosis. Presently, limited data are available regarding the late safety of this therapeutic modality. The aim of the study was to determine the incidence of late (>1 month) thrombosis after PTCA and radiotherapy. METHODS AND RESULTS: From April 1997 to March 1999, we successfully treated 108 patients with PTCA followed by intracoronary beta-radiation. Ninety-one patients have completed at least 2 months of clinical follow-up. Of these patients, 6.6% (6 patients) presented with sudden thrombotic events confirmed by angiography 2 to 15 months after intervention (2 balloon angioplasty and 4 stent). Some factors (overlapping stents, unhealed dissection) may have triggered the thrombosis process, but the timing of the event is extremely unusual. Therefore, the effect of radiation on delaying the healing process and maintaining a thrombogenic coronary surface is proposed as the most plausible mechanism to explain such late events. CONCLUSIONS: Late and sudden thrombosis after PTCA followed by intracoronary radiotherapy is a new phenomenon in interventional cardiology.
Costa et al. (1999) conducted an observational in Coronary artery disease requiring PTCA (n=108). Intracoronary beta-radiation (brachytherapy) was evaluated on Incidence of late (>1 month) thrombosis. Intracoronary beta-radiation after percutaneous transluminal coronary angioplasty was associated with a 6.6% incidence of late and sudden thrombosis occurring 2 to 15 months post-intervention.
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