Advertisement

Endovascular Brachytherapy to Prevent Restenosis After Percutaneous Coronary Intervention

  • Jörg Kotzerke
  • Sigmund Silber
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Radiation can prevent not only keloid scar formation at the skin but also an excess of intraluminal neointimal proliferation following injury of balloon angioplasty. This was demonstrated in animal models of restenosis and was validated in multiple clinical trials. Beta irradiation was as effective as gamma irradiation, however, low dose radioactive stents caused edge stenosis. Filling a balloon catheter with a radioactive solution (e.g. rhenium-188-perrhenate) restenosis could be prevented or at least delayed which was demonstrated in in-stent restenosis as well as in de novo stenosis. Late thrombosis of irradiated bare metal stents has been overcome by dual antiplatelet treatment for 12 months. Recommendations and standardizations for vascular brachytherapy were developed to secure this highly interdisciplinary approach. However, the interest in this technique vanished when drug-eluting stents were available which can be delivered by the interventionalist alone without the limitations and expenditure from application of irradiation. Nevertheless, intracoronary brachytherapy with isotope-filled balloons or beta radiation is still applied in some specialized centers.

Keywords

Percutaneous Coronary Intervention Balloon Catheter Major Adverse Cardiac Event Bare Metal Stents Target Lesion Revascularization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Ajani AE, Waksman R, Cheneau E et al (2002) Elderly patients have a favorable outcome after intracoronary radiation for in-stent restenosis. Catheter Cardiovasc Interv 56:466–471PubMedGoogle Scholar
  2. Albiero R, Nishida T, Adamian M et al (2000) Edge restenosis after implantation of high activity (32) P radioactive beta-emitting stents. Circulation 101:2454–2457PubMedGoogle Scholar
  3. Amols HI, Reinstein LE, Weinberger J (1996a) Dosimetry of a radioactive coronary balloon dilatation catheter for treatment of neointimal hyperplasia. Med Phys 23:1783–1788PubMedGoogle Scholar
  4. Amols HI, Zaider M, Weinberger J et al (1996b) Dosimetric considerations for catheter-based beta and gamma emitters in the therapy of neointimal hyperplasia in human coronary arteries. Int J Radiat Oncol Biol Phys 36:913–921PubMedGoogle Scholar
  5. Amols HI, Trichter F, Weinberger J (1998) Intracoronary radiation for prevention of restenosis: dose perturbations caused by stents. Circulation 98:2024–2029PubMedGoogle Scholar
  6. Austin GE, Ratliff NB, Hollman J et al (1985) Intimal proliferation of smooth muscle cells as an explanation for recurrent coronary artery stenosis after percutaneous transluminal coronary angioplasty. J Am Coll Cardiol 6:369–375PubMedGoogle Scholar
  7. Califf RM, Fortin DF, Frid DJ et al (1991) Restenosis after coronary angioplasty: an overview. J Am Coll Cardiol 17:2B–13BPubMedGoogle Scholar
  8. Callahan AP, Rice DE, Knapp jr FF (1989) Rhenium-188 for therapeutic applications from a alumina-based tungsten-188/rhenium-188 radionuclide generator. Nuc Compact 20:3–6Google Scholar
  9. Carter AJ, Laird JR (1996) Experimental results with endovascular irradiation via a radioactive stent. Int J Radiat Oncol Biol Phys 36:797–803PubMedGoogle Scholar
  10. Cho YS, Kim MA, Hwang KK et al (2004) Two-year clinical follow-up results of intracoronary radiation therapy with rhenium-188-diethylene triamine penta-acetic acid-filled balloon. Catheter Cardiovasc Interv 63:274–281PubMedGoogle Scholar
  11. Cohen DJ, Breall JA, Ho KK et al (1994) Evaluating the potential cost-effectiveness of stenting as a treatment for symptomatic single-vessel coronary disease Use of a decision-analytic model. Circulation 89:1859–1874PubMedGoogle Scholar
  12. Condado JA, Waksman R, Gurdiel O et al (1997) Long-term angiographic and clinical outcome after percutaneous transluminal coronary angioplasty and intracoronary radiation therapy in humans. Circulation 96:727–732PubMedGoogle Scholar
  13. Costantini CO, Lansky AJ, Mintz GS et al (2003) Intravascular brachytherapy for native coronary ostial in-stent restenotic lesions. J Am Coll Cardiol 41:1725–1731PubMedGoogle Scholar
  14. Coursey BM, Colle R, Zimmerman BE et al (1998) National radioactivity standards for beta-emitting radionuclides used in intravascular brachytherapy. Int J Radiat Oncol Biol Phys 41:207–216PubMedGoogle Scholar
  15. Dietz R, Silber S, Baumgart D et al (2001) Position paper on intracoronary brachytherapy. Z Kardiol 90:875–880PubMedGoogle Scholar
  16. Ellis SG, O’Shaughnessy CD, Martin SL et al (2008) Two-year clinical outcomes after paclitaxel-eluting stent or brachytherapy treatment for bare metal stent restenosis: the TAXUS V ISR trial. Eur Heart J 29:1625–1634PubMedGoogle Scholar
  17. Fischman DL, Leon MB, Baim DS et al (1994) A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. Stent restenosis study investigators. N Engl J Med 331:496–501PubMedGoogle Scholar
  18. Fox RA (1997) Dosimetry of beta emitting radionuclides for use in balloon angioplasty. Australas Phys Eng Sci Med 20:139–146PubMedGoogle Scholar
  19. Fox RA, Henson PW (1999) The effect of contrast medium and balloon shape on dosimetry for arterial irradiation with Re-188. Med Phys 26:771–776PubMedGoogle Scholar
  20. Fox RA, Barker P, Smart G (1999) The use of GAFchromic film to determine the absolute activity of beta emitters. Phys Med Biol 44:833–842PubMedGoogle Scholar
  21. Friedman M, Felton L, Byers S (1964) The Antiatherogenic effect of iridium-192 upon the cholesterol-fed rabbit. J Clin Invest 43:185–192PubMedCentralPubMedGoogle Scholar
  22. Grise MA, Massullo V, Jani S et al (2002) Five-year clinical follow-up after intracoronary radiation: results of a randomized clinical trial. Circulation 105:2737–2740PubMedGoogle Scholar
  23. Gruberg L, Waksman R, Ajani AE et al (2002) The effect of intracoronary radiation for the treatment of recurrent in-stent restenosis in patients with diabetes mellitus. J Am Coll Cardiol 39:1930–1936PubMedGoogle Scholar
  24. Haase J, von Neumann-Cosel P, Damm M et al (2005) Comparison of a centered 32P source wire system with a noncentered 90Sr/Y brachytherapy system for intracoronary beta-radiation following PCI of diffuse in-stent restenosis. Cardiovasc Revasc Med 6:140–146PubMedGoogle Scholar
  25. Hafeli UO, Warburton MC, Landau U (1998) Electrodeposition of radioactive rhenium onto stents to prevent restenosis. Biomaterials 19:925–933PubMedGoogle Scholar
  26. Hausleiter J, Li A, Makkar R et al (2000) Leakage of a liquid 188Re-filled balloon system during intracoronary brachytherapy. A case report. Cardiovasc Radiat Med 2:7–10Google Scholar
  27. Hehrlein C, Gollan C, Donges K et al (1995) Low-dose radioactive endovascular stents prevent smooth muscle cell proliferation and neointimal hyperplasia in rabbits. Circulation 92:1570–1575PubMedGoogle Scholar
  28. Hehrlein C, Stintz M, Kinscherf R et al (1996) Pure beta-particle-emitting stents inhibit neointima formation in rabbits. Circulation 93:641–645PubMedGoogle Scholar
  29. Herrmann T (2001) Recommendations of the radiation protection commission on endovascular radiation therapy. Strahlenther Onkol 177:501–503PubMedGoogle Scholar
  30. Hoher M, Wohrle J, Wohlfrom M et al (2000) Intracoronary beta-irradiation with a liquid (188) re-filled balloon: six-month results from a clinical safety and feasibility study. Circulation 101:2355–2360PubMedGoogle Scholar
  31. Hoher M, Wohrle J, Wohlfrom M et al (2003) Intracoronary beta-irradiation with a rhenium-188-filled balloon catheter: a randomized trial in patients with de novo and restenotic lesions. Circulation 107:3022–3027PubMedGoogle Scholar
  32. Holmes DR Jr, Teirstein P, Satler L et al (2006) Sirolimus-eluting stents vs vascular brachytherapy for in-stent restenosis within bare-metal stents: the SISR randomized trial. JAMA 295:1264–1273PubMedGoogle Scholar
  33. Holmes DR Jr, Teirstein PS, Satler L et al (2008) 3-year follow-up of the SISR (sirolimus-eluting stents versus vascular brachytherapy for in-stent restenosis) trial. JACC Cardiovasc Interv 1:439–448PubMedGoogle Scholar
  34. Hong MK, Park SW, Moon DH et al (2002) Impact of geographic miss on adjacent coronary artery segments in diffuse in-stent restenosis with beta-radiation therapy: angiographic and intravascular ultrasound analysis. Am Heart J 143:327–333PubMedGoogle Scholar
  35. Hong MK, Park SW, Moon DH et al (2003a) Extra-stent vascular modeling in in-stent restenosis after 188Re-MAG3 radiation therapy. Int J Cardiol 92:201–205Google Scholar
  36. Hong MK, Park SW, Moon DH et al (2003b) Intravascular ultrasound analysis of nonstented adjacent segments in diffuse in-stent restenosis treated with radiation therapy with a rhenium-188-filled balloon. Catheter Cardiovasc Interv 58:428–433PubMedGoogle Scholar
  37. Hong MK, Mintz GS, Lee CW et al (2004) Late intravascular ultrasound findings of patients treated with brachytherapy for diffuse in-stent restenosis. Catheter Cardiovasc Interv 63:208–214PubMedGoogle Scholar
  38. Janicki C, Duggan DM, Coffey CW et al (1997) Radiation dose from a phosphorous-32 impregnated wire mesh vascular stent. Med Phys 24:437–445PubMedGoogle Scholar
  39. Knapp FF Jr, Beets AL, Guhlke S et al (1997) Availability of rhenium-188 from the alumina-based tungsten-188/rhenium-188 generator for preparation of rhenium-188-labeled radiopharmaceuticals for cancer treatment. Anticancer Res 17:1783–1795PubMedGoogle Scholar
  40. Koo BK, Lee MM, Oh S et al (2004) Effects of beta-radiation with a 188rhenium-filled balloon catheter system on non-stented adjacent coronary artery segments. Int J Cardiol 96:73–77PubMedGoogle Scholar
  41. Kotzerke J, Fenchel S, Guhlmann A et al (1998a) Pharmacokinetics of 99Tcm-pertechnetate and 188Re-perrhenate after oral administration of perchlorate: option for subsequent care after the use of liquid 188Re in a balloon catheter. Nucl Med Commun 19:795–801PubMedGoogle Scholar
  42. Kotzerke J, Rentschler M, Glatting G et al (1998b) Dosimetry fundamentals of endovascular therapy using Re-188 for the prevention of restenosis after angioplasty. Nuklearmedizin 37:68–72PubMedGoogle Scholar
  43. Kotzerke J, Hanke H, Hoher M (2000) Endovascular brachytherapy for the prevention of restenosis after angioplasty. Eur J Nucl Med 27:223–236PubMedGoogle Scholar
  44. Kupersmith J, Holmes Rovner M, Hogan A et al (1994) Cost-effectiveness analysis in heart disease, Part I: general principles. Prog Cardiovasc Dis 37:161–184PubMedGoogle Scholar
  45. Kupersmith J, Holmes Rovner M, Hogan A et al (1995) Cost-effectiveness analysis in heart disease, part II: preventive therapies. Prog Cardiovasc Dis 37:243–271PubMedGoogle Scholar
  46. Lee J, Lee DS, Kim KM et al (2000) Dosimetry of rhenium-188 diethylene triamine penta-acetic acid for endovascular intra-balloon brachytherapy after coronary angioplasty. Eur J Nucl Med 27:76–82PubMedGoogle Scholar
  47. Lee SW, Park SW, Hong MK et al (2005a) Comparison of angiographic and clinical outcomes between rotational atherectomy and cutting balloon angioplasty followed by radiation therapy with a rhenium 188-mercaptoacetyltriglycine-filled balloon in the treatment of diffuse in-stent restenosis. Am Heart J 150:577–582PubMedGoogle Scholar
  48. Lee SW, Park SW, Hong MK et al (2005b) Long-term outcomes after treatment of diffuse in-stent restenosis with rotational atherectomy followed by beta-radiation therapy with a 188Re-MAG3-filled balloon. Int J Cardiol 99:201–205PubMedGoogle Scholar
  49. Lee SW, Park SW, Hong MK et al (2005c) Comparison of angiographic and clinical outcomes between rotational atherectomy versus balloon angioplasty followed by radiation therapy with a rhenium-188-mercaptoacetyltriglycine-filled balloon in the treatment of diffuse in-stent restenosis. Int J Cardiol 102:179–185PubMedGoogle Scholar
  50. Lee SW, Park SW, Hong MK et al (2006) Incidence and predictors of late recurrence after beta-radiation therapy with a 188Re-MAG3-filled balloon for diffuse in-stent restenosis. Am Heart J 151:158–163PubMedGoogle Scholar
  51. Lee SW, Park SW, Park DW et al (2007) Comparison of six-month angiographic and three-year outcomes after sirolimus-eluting stent implantation versus brachytherapy for bare metal in-stent restenosis. Am J Cardiol 100:425–430PubMedGoogle Scholar
  52. Leon MB, Teirstein PS, Moses JW et al (2001) Localized intracoronary gamma-radiation therapy to inhibit the recurrence of restenosis after stenting. N Engl J Med 344:250–256PubMedGoogle Scholar
  53. Libby P, Schwartz D, Brogi E et al (1992) A cascade model for restenosis. A special case of atherosclerosis progression. Circulation 86:Iii47–Iii52Google Scholar
  54. Liermann D, Bottcher HD, Kollath J et al (1994) Prophylactic endovascular radiotherapy to prevent intimal hyperplasia after stent implantation in femoropopliteal arteries. Cardiovasc Intervent Radiol 17:12–16PubMedGoogle Scholar
  55. Lin WY, Tsai SC, Hsieh BT et al (2000) Evaluation of three rhenium-188 candidates for intravascular radiation therapy with liquid-filled balloons to prevent restenosis. J Nucl Cardiol 7:37–42PubMedGoogle Scholar
  56. Mazur W, Ali MN, Khan MM et al (1996) High dose rate intracoronary radiation for inhibition of neointimal formation in the stented and balloon-injured porcine models of restenosis: angiographic, morphometric, and histopathologic analyses. Int J Radiat Oncol Biol Phys 36:777–788PubMedGoogle Scholar
  57. Nath R, Amols H, Coffey C et al (1999) Intravascular brachytherapy physics: report of the AAPM radiation therapy committee task group no. 60. American association of physicists in medicine. Med Phys 26:119–152PubMedGoogle Scholar
  58. Oh SJ, Moon DH, Lee WW et al (2003) Automated preparation of 188Re-labeled radiopharmaceuticals for endovascular radiation therapy. Appl Radiat Isot 59:225–230PubMedGoogle Scholar
  59. Park SW, Hong MK, Moon DH et al (2001) Treatment of diffuse in-stent restenosis with rotational atherectomy followed by radiation therapy with a rhenium-188-mercaptoacetyltriglycine-filled balloon. J Am Coll Cardiol 38:631–637PubMedGoogle Scholar
  60. Park SW, Lee SW, Koo BK et al (2008) Treatment of diffuse in-stent restenosis with drug-eluting stents vs. intracoronary beta-radiation therapy: INDEED Study. Int J Cardiol 131:70–77PubMedGoogle Scholar
  61. Popma JJ, Suntharalingam M, Lansky AJ et al (2002) Randomized trial of 90Sr/90Y beta-radiation versus placebo control for treatment of in-stent restenosis. Circulation 106:1090–1096PubMedGoogle Scholar
  62. Popowski Y, Verin V, Papirov I et al (1995) Intra-arterial 90Y brachytherapy: preliminary dosimetric study using a specially modified angioplasty balloon. Int J Radiat Oncol Biol Phys 33:713–717PubMedGoogle Scholar
  63. Potter R, Van Limbergen E, Dries W et al (2001) Prescribing, recording, and reporting in endovascular brachytherapy. quality assurance, equipment, personnel and education. Radiother Oncol 59:339–360PubMedGoogle Scholar
  64. Price MJ, Giap H, Teirstein PS (2007) Intracoronary radiation therapy for multi-drug resistant in-stent restenosis: initial clinical experience. Catheter Cardiovasc Interv 69:132–134PubMedGoogle Scholar
  65. Quast U, Kaulich TW, Lorenz J (2002) Optimal intravascular brachytherapy: safety and radiation protection, reliability and precision guaranteed by guidelines, recommendations and regulatory requirements. Herz 27:7–16PubMedGoogle Scholar
  66. Raizner AE, Oesterle SN, Waksman R et al (2000) Inhibition of restenosis with beta-emitting radiotherapy: Report of the proliferation reduction with vascular energy trial (PREVENT). Circulation 102:951–958PubMedGoogle Scholar
  67. Reeder GS, Krishan I, Nobrega FT et al (1984) Is percutaneous coronary angioplasty less expensive than bypass surgery? N Engl J Med 311:1157–1162PubMedGoogle Scholar
  68. Regar E, Kozuma K, Sianos G et al (2002) Routine intracoronary beta-irradiation. Acute and one year outcome in patients at high risk for recurrence of stenosis. Eur Heart J 23:1038–1044PubMedGoogle Scholar
  69. Reynen K, Kockeritz U, Kropp J et al (2004) Intracoronary radiotherapy with a (188)rhenium liquid-filled PTCA balloon system in in-stent restenosis: acute and long-term angiographic results, as well as 1-year clinical follow-up. Int J Cardiol 95:29–34PubMedGoogle Scholar
  70. Rubin P, Williams JP, Riggs PN et al (1998) Cellular and molecular mechanisms of radiation inhibition of restenosis. Part I: role of the macrophage and platelet-derived growth factor. Int J Radiat Oncol Biol Phys 40:929–941PubMedGoogle Scholar
  71. Sabate M (2009) Secondary revascularisation following intracoronary brachytherapy. EuroIntervention 5(D):D121–D126PubMedGoogle Scholar
  72. Sapirstein W, Zuckerman B, Dillard J (2001) FDA approval of coronary-artery brachytherapy. N Engl J Med 344:297–299PubMedGoogle Scholar
  73. Scheller B, Hehrlein C, Bocksch W et al (2006) Treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. N Engl J Med 355:2113–2124PubMedGoogle Scholar
  74. Schmid R, Kirisits C, Syeda B et al (2004) Quality assurance in intracoronary brachytherapy. recommendations for determining the planning target length to avoid geographic miss. Radiother Oncol 71:311–318PubMedGoogle Scholar
  75. Schuhlen H, Eigler N, Whiting JS et al (2001) Usefulness of intracoronary brachytherapy for in-stent restenosis with a 188Re liquid-filled balloon. Am J Cardiol 87(463–6):A7Google Scholar
  76. Schwartz RS, Holmes DR Jr, Topol EJ (1992) The restenosis paradigm revisited: an alternative proposal for cellular mechanisms. J Am Coll Cardiol 20:1284–1293PubMedGoogle Scholar
  77. Serruys PW, Kay IP (2000) I like the candy, I hate the wrapper: the (32) P radioactive stent. Circulation 101:3–7PubMedGoogle Scholar
  78. Sharma AK, Ajani AE, Garg N et al (2003) Usefulness of gamma intracoronary radiation for totally occluded in-stent restenotic coronary narrowing. Am J Cardiol 91:595–597PubMedGoogle Scholar
  79. Shirai K, Lansky AJ, Mintz GS et al (2003) Comparison of the angiographic outcomes after beta versus gamma vascular brachytherapy for treatment of in-stent restenosis. Am J Cardiol 92:1409–1413PubMedGoogle Scholar
  80. Silber S (2002) Intracoronary radiation therapy in controlled and open clinical trials with afterloading systems and “hot” balloon catheters. Analysis of 6,692 patients. Herz 27:30–55PubMedGoogle Scholar
  81. Silber S, Popma JJ, Suntharalingam M et al (2005a) Two-year clinical follow-up of 90Sr/90 Y beta-radiation versus placebo control for the treatment of in-stent restenosis. Am Heart J 149:689–694PubMedGoogle Scholar
  82. Silber S, Albertsson P, Aviles FF, Camici PG, Colombo A, Hamm C, Jorgensen E, Marco J, Nordrehaug JE, Ruzyllo W, Urban P, Stone GW, Wijns W (2005b) Guidelines for percutaneous coronary interventions. The task force for percutaneous coronary interventions of the European Society of Cardiology. Eur Heart J 26:804-47.Google Scholar
  83. Silber S, Borggrefe M, Bohm M et al (2008) Drug-eluting coronary stents and drug eluting balloon catheters: summary of the position papers of the DGK. Clin Res Cardiol 97:548–563PubMedGoogle Scholar
  84. Silber S, Studiengruppe fdB (2001). Die BETACATH Studie 67 Jahrestagung der Deutschen Gesellschaft für Kardiologie., MannheimGoogle Scholar
  85. Stoll HP, Hutchins GD, Winkle WL et al (2001) Advantages of short-lived positron-emitting radioisotopes for intracoronary radiation therapy with liquid-filled balloons to prevent restenosis. J Nucl Med 42:1375–1383PubMedGoogle Scholar
  86. Stone GW, Mehran R, Midei M et al (2003) Usefulness of beta radiation for de novo and in-stent restenotic lesions in saphenous vein grafts. Am J Cardiol 92:312–314PubMedGoogle Scholar
  87. Stone GW, Ellis SG, O’Shaughnessy CD et al (2006) Paclitaxel-eluting stents vs vascular brachytherapy for in-stent restenosis within bare-metal stents: the TAXUS V ISR randomized trial. JAMA 295:1253–1263PubMedGoogle Scholar
  88. Teirstein PS (1998) Gamma versus beta radiation for the treatment of restenosis. Herz 23:335–336PubMedGoogle Scholar
  89. Teirstein PS, Kuntz RE (2001) New frontiers in interventional cardiology: intravascular radiation to prevent restenosis. Circulation 104:2620–2626PubMedGoogle Scholar
  90. Teirstein PS, Massullo V, Jani S et al (1997) Catheter-based radiotherapy to inhibit restenosis after coronary stenting. N Engl J Med 336:1697–1703PubMedGoogle Scholar
  91. Teirstein PS, Massullo V, Jani S et al (2000) Three-year clinical and angiographic follow-up after intracoronary radiation : results of a randomized clinical trial [see comments]. Circulation 101:360–365PubMedGoogle Scholar
  92. Thomas MR (2005) Brachytherapy: here today, gone tomorrow? Heart 91(3):iii32–iii34PubMedCentralPubMedGoogle Scholar
  93. Torguson R, Sabate M, Deible R et al (2006) Intravascular brachytherapy versus drug-eluting stents for the treatment of patients with drug-eluting stent restenosis. Am J Cardiol 98:1340–1344PubMedGoogle Scholar
  94. Uchida T, Bakhai A, Almonacid A et al (2006) A meta-analysis of randomized controlled trials of intracoronary gamma-and beta-radiation therapy for in-stent restenosis. Heart Vessels 21:368–374PubMedGoogle Scholar
  95. Urban P, Serruys P, Baumgart D et al (2003) A multicentre European registry of intraluminal coronary beta brachytherapy. Eur Heart J 24:604–612PubMedGoogle Scholar
  96. Verin V, Popowski Y, Urban P et al (1995) Intra-arterial beta irradiation prevents neointimal hyperplasia in a hypercholesterolemic rabbit restenosis model. Circulation 92:2284–2290PubMedGoogle Scholar
  97. Verin V, Urban P, Popowski Y et al (1997) Feasibility of intracoronary beta-irradiation to reduce restenosis after balloon angioplasty. A clinical pilot study. Circulation 95:1138–1144Google Scholar
  98. Waksman R (1998) Intracoronary brachytherapy in the cath lab. physics dosimetry, technology and safety considerations. Herz 23:401–406PubMedGoogle Scholar
  99. Waksman R, Robinson KA, Crocker IR et al (1995) Intracoronary low-dose beta-irradiation inhibits neointima formation after coronary artery balloon injury in the swine restenosis model. Circulation 92:3025–3031PubMedGoogle Scholar
  100. Waksman R, Rodriguez JC, Robinson KA et al (1997) Effect of intravascular irradiation on cell proliferation, apoptosis, and vascular remodeling after balloon overstretch injury of porcine coronary arteries. Circulation 96:1944–1952PubMedGoogle Scholar
  101. Waksman R, White RL, Chan RC et al (2000) Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis. Circulation 101:2165–2171PubMedGoogle Scholar
  102. Waksman R, Ajani AE, White RL et al (2001) Two-year follow-up after beta and gamma intracoronary radiation therapy for patients with diffuse in-stent restenosis. Am J Cardiol 88:425–428PubMedGoogle Scholar
  103. Waksman R, Ajani AE, White RL et al (2002a) Intravascular gamma radiation for in-stent restenosis in saphenous-vein bypass grafts. N Engl J Med 346:1194–1199PubMedGoogle Scholar
  104. Waksman R, Raizner AE, Yeung AC et al (2002b) Use of localised intracoronary beta radiation in treatment of in-stent restenosis: the INHIBIT randomised controlled trial. Lancet 359:551–557PubMedGoogle Scholar
  105. Waksman R, Lew R, Ajani AE et al (2003) Repeat intracoronary radiation for recurrent in-stent restenosis in patients who failed intracoronary radiation. Circulation 108:654–656PubMedGoogle Scholar
  106. Waksman R (2011) Vascular brachytherapy: a landmark chapter in the field of interventional cardiology. EuroIntervention 6:669–671PubMedGoogle Scholar
  107. Weinberger J (1998) Intracoronary radiation using radioisotope solution-filled balloons. Herz 23:366–372PubMedGoogle Scholar
  108. Weinberger J (1999) Use of liquid-filled balloons for coronary irradiation. In: Waksman R (ed) Vascular Brachytherapy. Futura Publishing Company, Armonk, pp 521–536Google Scholar
  109. Wiedermann JG, Marboe C, Amols H et al (1994) Intracoronary irradiation markedly reduces restenosis after balloon angioplasty in a porcine model. J Am Coll Cardiol 23:1491–1498PubMedGoogle Scholar
  110. Wiedermann JG, Marboe C, Amols H et al (1995) Intracoronary irradiation markedly reduces neointimal proliferation after balloon angioplasty in swine: persistent benefit at 6-month follow-up. J Am Coll Cardiol 25:1451–1456PubMedGoogle Scholar
  111. Wilcox JN, Waksman R, King SB et al (1996) The role of the adventitia in the arterial response to angioplasty: the effect of intravascular radiation. Int J Radiat Oncol Biol Phys 36:789–796PubMedGoogle Scholar
  112. Wohlfrom M, Kotzerke J, Kamenz J et al (2001) Endovascular irradiation with the liquid beta-emitter Rhenium-188 to reduce restenosis after experimental wall injury. Cardiovasc Res 49:169–176PubMedGoogle Scholar
  113. Wohrle J, Krause BJ, Nusser T et al (2006a) Repeat intracoronary beta-brachytherapy using a rhenium-188-filled balloon catheter for recurrent restenosis in patients who failed intracoronary radiation therapy. Cardiovasc Revasc Med 7:2–6PubMedGoogle Scholar
  114. Wohrle J, Krause BJ, Nusser T et al (2006b) Intracoronary beta-brachytherapy using a rhenium-188 filled balloon catheter in restenotic lesions of native coronary arteries and venous bypass grafts. Eur J Nucl Med Mol Imaging 33:1314–1320PubMedGoogle Scholar
  115. Wunderlich G, Hartmann H, Andreeff M et al (2008) A semi-automated system for concentration of rhenium-188 for radiopharmaceutical applications. Appl Radiat Isot 66:1876–1880PubMedGoogle Scholar
  116. Yue N, Roberts K, Nath R (2004) Effects of vessel curvature on dose distributions in catheter-based intravascular brachytherapy for various radionuclides. Cardiovasc Radiat Med 5:142–150PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg  2012

Authors and Affiliations

  1. 1.Klinik und Poliklinik für NuklearmedizinUniversitätsklinikum DresdenDresdenGermany
  2. 2.Kardiologische Praxis und Praxisklinik, Heart Center at the IsarMünchenGermany

Personalised recommendations