The use of188Re to treat in-stent re-stenosis of coronary arteries

Ra, Fox; Barker, P; Guy, David; Smart, G; Henson, P.W.; Mews, Geoffrey C.; Gibbons, F.

doi:10.1007/bf03178358

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…There was no failure of irradiation technique or dose delivery. Our results confirm the positive findings of previous pilot studies with rhenium-188 perrhenate [11][12][13] and a nonrandomized series of patients undergoing rhenium-188 mercaptoacetyltriglycine brachytherapy after atherectomy. 14 Compared with other irradiation devices, the rhenium-188 liquid-filled balloon provides various advantages.…”

Section: Discussionsupporting

confidence: 90%

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Intracoronary β-Irradiation With a Rhenium-188–Filled Balloon Catheter

et al. 2003

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Background-Restenosis requiring reintervention is the main limitation of coronary angioplasty. Intracoronary irradiation reduces neointimal proliferation. We studied the efficacy of a self-centering liquid rhenium-188 -filled balloon catheter for coronary ␤-brachytherapy. Methods and Results-After successful coronary angioplasty with or without stenting, 225 patients (71% de novo lesions)were randomly assigned to receive 22.5 Gy intravascular ␤-irradiation in 0.5-mm tissue depth (nϭ113) or to receive no additional intervention (nϭ112). Clinical and procedural data did not differ between the groups except a higher rate of stenting in the control group (63%) compared with the rhenium-188 group (45%, PϽ0.02). After 6 months of follow-up, late loss was significantly lower in the irradiated group compared with the control group, both of the target lesion (0.11Ϯ0.54 versus 0.69Ϯ0.81 mm, PϽ0.0001) and of the total segment (0.22Ϯ0.67 versus 0.70Ϯ0.82 mm, PϽ0.0001). This was also evident in the subgroup of patients with de novo lesions and independent from stenting. Binary restenosis rates were significantly lower at the target lesion (6.3% versus 27.5%, PϽ0.0001) and of the total segment (12.6% versus 28.6%, PϽ0.007) after rhenium-188 brachytherapy compared with the control group. Target vessel revascularization rate was significantly lower in the rhenium-188 (6.3%) compared with the control group (19.8%, Pϭ0.006). Conclusions-Intracoronary ␤-brachytherapy with a rhenium-188 liquid-filled balloon is safe and efficiently reduces restenosis and revascularization rates after coronary angioplasty.

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Section: Discussionsupporting

confidence: 90%

“…However, the restenosis rate of the total segment was 46% because of edge stenoses and geographical miss. Other pilot trials with rhenium-188 balloon brachytherapy using 28 Gy (nϭ11) 12 and 30 Gy (nϭ26 13 and nϭ50 14 ) in 0.5-mm tissue depth to treat in-stent restenosis revealed an angiographic restenosis rate of 10% to 18% at 6 months.…”

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confidence: 99%

Intracoronary β-Irradiation With a Rhenium-188–Filled Balloon Catheter

et al. 2003

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“…It was, however, a coincidental forerunner to a new and important intravascular technique developed for the treatment of stenosis in heart disease. The first work published in APESM was in 2001 [78][79][80][81] . This research was a combined clinical trial involving the Royal Perth Hospital cardiologists and medical physicists.…”

Section: Extracorporeal Brachytherapymentioning

confidence: 99%

Thirty year celebration of journal publications on radiation oncology medical physics

Oliver

2007

Australas. Phys. Eng. Sci. Med.

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The Australasian Physical & Engineering Sciences in Medicine Journal (APESM) is an avenue for the profession to report scientific work in medicine; provide a facility for the publication of current work, new research and new techniques developed or reviewed; report on professional news from elsewhere and; publish the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) policies and protocols. The journal is a vital instrument within the ACPSEM organisation with a worldwide circulation. This review of APESM on medical physics in radiation oncology is meant to be a progress summary of work in that specialty. Even so, it has become a lengthy appraisal due to the many years involved. In considering publications related to medical physics in radiation oncology, this review has shown the progression of the College journal to an international journal. There is an increase in the number of papers contributed from Asia and other countries world wide for this discipline. Growth in the number of contributions should continue to rise. In order to provide some appreciation of where the present medical physics activity arose from, this article commences its discussion in 1959 and progresses towards the present, describing along the way, from radiation oncology papers published in APESM, the use of linear accelerators, brachytherapy, the medical physics workforce, the formation of the ACPSEM, and the more modern developments in radiotherapy such as 3-D treatment planning and IMRT.

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“…The total activity required for this technique if treatment times are to be kept below 5 min is of the order of 10 GBq. Techniques can be introduced (Fox et al 2001) which reduce the potential for contamination and keep staff doses at acceptable levels. However, there is inevitably more risk of a radiation incident with such a treatment method compared with the use of a sealed source.…”

Section: Liquids In the Angioplasty Balloonmentioning

confidence: 99%

Intravascular brachytherapy of the coronary arteries

2002

Phys. Med. Biol.

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This is a review of the relatively recently developed field of intravascular brachytherapy of coronary arteries. It presents a brief overview of the discipline of coronary angioplasty describing the problem of restenosis and discusses the potential for ionizing radiation to overcome this problem. It examines the various methods that have been used to irradiate the coronary arteries comparing their advantages and disadvantages. Special consideration is given to seeds and wires in the artery, radioactive liquids in the angioplasty balloon and radioactive stents. Passing reference is made to a number of other methods that have also been proposed, but which are not commonly used to irradiate the coronary arteries at present. The dosimetry of each of the major techniques is discussed and the data from different laboratories compared. Specific consideration is given to the need for centring of the radioactive source and the factors affecting the selection of a dose prescription. A brief review of recent clinical trials is followed by an examination of possible future directions in this field including the use of intravascular ultrasound to improve dosimetry, the use of gas-filled balloons to enhance the penetration of beta-emitting sources and the use of gamma-emitting stents to overcome the problems associated with edge restenosis.

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The use of188Re to treat in-stent re-stenosis of coronary arteries

Cited by 7 publications

References 16 publications

Intracoronary β-Irradiation With a Rhenium-188–Filled Balloon Catheter

Intracoronary β-Irradiation With a Rhenium-188–Filled Balloon Catheter

Thirty year celebration of journal publications on radiation oncology medical physics

Intravascular brachytherapy of the coronary arteries

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