773-5 Percutaneous Translumlnal Coronary Angioplasty (PTCA) and Intracoronary Radiation Therapy (ICRT): A Possible New Modality for the Treatment of Coronary Restenosis: A Preliminary Report of the First 10 Patients Treated with Intracoronary Radiation Therapy
| Autor: | Juan Gonzales Brito, Samuel F. Liprie, Mark L. Harrison, Lee Roy Joyner, Raúl Espinoza, Orlando Gurdiel, José Ant Condado |
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| Rok vydání: | 1995 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment medicine.disease Chest pain Angina Coronary arteries medicine.anatomical_structure Restenosis Internal medicine Right coronary artery medicine.artery Angioplasty Angiography medicine Cardiology Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Journal of the American College of Cardiology. 25:288A |
| ISSN: | 0735-1097 |
| Popis: | Presently, there is no effective drug or device therapy to reduce coronary restenosis after angioplasty, There is now evidence that low dose radiation inhibits the process of intimal hyperplasia and prevents restenosis in the coronary porcine model and in the superficial femoral artery in humans, On July 28, 1994, the first precision dose of radiation therapy was delivered percutaneously into the human coronary artery. It is the intent of this investigation to determine if immediate low dose ICRT delivered directly to the angioplasty site will prevent the subsequent development of restenosis.10 patients (8 male a 2 female) from age 36 to 66 (average age of 52) with clinical ischemic heart disease (angina and transient ST segment abnormalities) underwent PTCA-ICRT. 13 coronary segments in 11 arteries were treated consisting of 85% (11/13) Type B and 15% (2/13) Type C lesions. The anatomy of the lesions consisted of 45% (5/11) left anterior descending artery, 27% (3/11) right coronary artery, 18% (2/11) left circumflex artery, and 9% (1/11) ramus intermedius artery. Standard periprocedural therapy included aspirin, heparin, intracoronary nitroglycerin, and calcium channel antagonists. An Iridium 192 source wire was afterloaded through a coronary catheter system. The source wire was positioned at the angioplasty site by measurement and by direct fluoroscopic visualization. A treatment dose of 2000 cGy was delivered to the intima of each coronary artery segment. The treatment times ranged from 5 to 15 minutes. The procedure was well tolerated. Slight chest pain was experienced by 2 patients. Mild spasm occurred in 8 of 11 treated coronary arteries which responded well to intracoronary nitroglycerin. Angiography performed immediately and 24 hours after PTCA-ICRT demonstrated that all treated coronary segments were widely patent. Continued follow-up and patient accrual are planned. All patients will be re-angiogramed 6 months after PTCA-ICRT. Conclusion lntracoronary Radiation Therapy can now be delivered safely and it is our hope that in the near future our expanding clinical study will demonstrate the efficacy of ICRT in reducing coronary restenosis. |
| Databáze: | OpenAIRE |
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