Intracoronary radiation to treat in-stent restenosis in six cardiac transplant patients

✍ Scribed by Mark A. Grise; John P. Reilly; Jonathan M. Tobis; Yuzuru Takano; Jesse W. Currier; Jon A. Kobashigawa; Giora Weisz; Jeffrey W. Moses; Martin B. Leon; Alan Yeung; Paul S. Teirstein

• Publisher: John Wiley and Sons
• Year: 2003
• Tongue: English
• Weight: 49 KB
• Volume: 60
• Category: Article
• ISSN: 1522-1946
• DOI: 10.1002/ccd.10607

✦ Synopsis

Abstract

Transplant vasculopathy significantly limits the survival of cardiac transplant patients and occurs in 50% of patients by 5 years posttransplant. We report our experience with six cardiac transplant patients who underwent intracoronary brachytherapy for in‐stent restenosis. At four centers, six patients underwent intracoronary radiation for in‐stent restenosis. All patients received extended antiplatelet therapy with clopidogrel and aspirin. Follow‐up angiography was performed in all patients. Two of the six patients underwent subsequent target lesion revascularization. Patient 1 presented with total occlusion of her radiated lesion. She had a complex procedure requiring stenting for a dissection after the radiation dwell. Patient 2 had high‐grade restenosis following brachytherapy. Patient 3 had a 50% restenotic lesion. Patients 4, 5, and 6 had follow‐up angiography that showed no evidence of restenosis. There are few good options to treated accelerated transplant vasculopathy. Radiation therapy may be a viable option in this difficult patient population. Catheter Cardiovasc Interv 2003;60:41–44. © 2003 Wiley–Liss, Inc.