Document Detail


Intracoronary radiation to treat in-stent restenosis in six cardiac transplant patients.
MedLine Citation:
PMID:  12929102     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  60     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-20     Completed Date:  2004-01-06     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-4     Citation Subset:  IM    
Copyright Information:
Copyright 2003 Wiley-Liss, Inc.
Affiliation:
Division of Cardiovascular Disease, Scripps Clinic, La Jolla, California 92037, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antibodies, Monoclonal / therapeutic use
Arteries / pathology,  radiation effects,  surgery
Aspirin / therapeutic use
Blood Vessel Prosthesis Implantation
Brachytherapy*
California
Coronary Angiography
Coronary Restenosis / diagnosis,  radiotherapy,  therapy*
Coronary Vessels / pathology,  radiation effects,  surgery
Female
Follow-Up Studies
Heart Transplantation*
Humans
Immunoglobulin Fab Fragments / therapeutic use
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Reoperation
Stents*
Ticlopidine / analogs & derivatives*,  therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; A74586SNO7/clopidogrel; X85G7936GV/abciximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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