HIGH-DOSE-RATE BRACHYTHERAPY FOR PREVENTION OF RESTENOSIS AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY - PRELIMINARY DOSIMETRIC TESTS OF A NEW SOURCE PRESENTATION
Y. Popowski et al., HIGH-DOSE-RATE BRACHYTHERAPY FOR PREVENTION OF RESTENOSIS AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY - PRELIMINARY DOSIMETRIC TESTS OF A NEW SOURCE PRESENTATION, International journal of radiation oncology, biology, physics, 33(1), 1995, pp. 211-215
Citations number
16
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: Balloon dilatation of coronary artery stenosis has become a s
tandard treatment of atherosclerotic heart disease. Restenosis due to
excessive intimal cell proliferation, which subsequently occurs in 20-
50% of patients, represents one of the major clinical problems in cont
emporary cardiology, and no satisfactory method for its prevention has
thus far been found. Because modest doses of radiation have proved ef
fective in preventing certain types of abnormal cellular proliferation
resulting from surgical trauma, and brachytherapy has already been us
ed successfully after dilatation of peripheral arteries, development o
f a radioactive source suitable for coronary artery applications would
be of great interest. Methods and Materials: Nonradioactive flexible
yttrium-89 wires (diameter of 0.15 and 0.26 mm) were activated within
the thermal neutron flux of an experimental reactor. Standard angiopla
sty balloons (2 cm long, 2.5 mm in diameter when inflated) were insert
ed for dosimetry into a specially manufactured tissue equivalent phant
om. Pour wells, drilled perpendicular to the axis of the balloon, allo
wed for the insertion of thermal luminescent dosimeters (TLDs; 2 mm of
diameter) and spacers. The angioplasty balloon was inflated with air
or with contrast media. Radioactive yttrium-90 wires were left in the
central lumen of the balloon for 2 min. Doses at the surface of the ba
lloon, and at 1, 2, and 3 mm were determined from TLD readings. Result
s: Doses obtained at the surface of the balloon, for a 2-min exposure
for the 0.26 mm wire (balloon inflated with air) and the 0.15 mm wire
(air or contrast), were 56.5 Gy, 17.8 Gy, 5.4 Gy, respectively. As exp
ected for a beta emitter, the fall-off in dose as a function of depth
was rapid. External irradiation from the beta source was negligible. C
onclusions: Our experiments indicate that the dose rates attainable at
the surface of the angioplasty balloon using this technique allow the
doses necessary for the inhibition of intimal cell proliferation to b
e reached within a relatively short period of time. The thin yttrium-9
0 wires are very easy to handle, and their mechanical and radioactive
properties are well suited to the requirements of the catheterization
procedure.