Treatment of bifurcation in-stent XXXX with beta radiation using strontium 90 and sequential positioning pullback technique: procedural details and clinical outcomes.

@entity75 @entity1 @entity439 @entity4122
BACKGROUND: In-stent @entity75 have been problematic for many @entity1 with the need for multiple repeat percutaneous coronary interventions (PCI). The need for repeat PCI has been significantly reduced in @entity1 since the advent of vascular brachytherapy. In-stent restenosis resulting in bifurcation presents even more of a challenge. The use of radiation therapy for the treatment of this kind of lesion has not yet been reported. The purpose of this paper is to present five cases of radiation therapy in bifurcation in-stent @entity75 using the intraluminal beta radiation catheter delivery system (Beta-Cath System, Novoste Corporation, Norcross, Georgia). METHODS: We reviewed the database of @entity1 enrolled in our Compassionate Use Registry between August 1999 and April 2002. The data is reported for 5 @entity1 who received radiation in both branches of bifurcation lesions with the Beta-Cath catheter system. RESULTS: The mean diameter of the vessels was 3.1 mm 0.5 mm. The dose administered was from 18.3 to 23 Gy, with an overlap of 3.3 to 10.3 mm; the hinge angle between the branches went from 43.3 to 65.4 . Angiographic follow-up was obtained at 6 months in 4 @entity1 , with a single @entity1 showing a focal (< 5 mm) edge lesion treated by balloon angioplasty (TVR no TLR). No @entity439 or zones of @entity4122 were noted. CONCLUSION: Beta radiation with the Beta-Cath catheter system appears to be safe, secure and clinically useful in in-stent restenotic bifurcation lesions.
