Coronary brachytherapy is a minimally invasive treatment for coronary artery disease (CAD). It uses radiation to remove scar tissue that can build up around stents (in-stent restenosis) and cause the arteries to narrow. It’s typically for people with multiple stents or recurring in-stent restenosis.
Coronary brachytherapy is a treatment for severe coronary artery disease (CAD). CAD develops when plaque builds up in the arteries that supply blood to your heart. Brachytherapy uses radiation to prevent scar tissue growth and keep your arteries open.
Other names for coronary brachytherapy are vascular brachytherapy (VBT), cardiac brachytherapy and adjunctive intracoronary radiation therapy.
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Coronary brachytherapy is typically for people with CAD who have already had treatment with percutaneous coronary intervention (PCI). PCI uses a small balloon and a stent (metal mesh tube) to open a blocked artery.
Sometimes scar tissue forms around the stent, causing the artery to narrow again. This condition is called in-stent restenosis (ISR). People with ISR may benefit from coronary brachytherapy.
You may be a candidate for brachytherapy if you have:
Coronary brachytherapy is only recommended for certain patients. You may not be a candidate if you’ve had:
There are other more common treatments for restenosis, including:
Coronary brachytherapy isn’t that common anymore. Newer stents that contain a slow-release drug (drug-eluting stents) have decreased the rate of restenosis to between 5% and 15%. As a result, not as many people need the treatment.
An interventional cardiologist and a radiation oncologist work together to perform coronary brachytherapy.
Your healthcare provider may order an imaging scan called an intravascular ultrasound to plan your surgery. The ultrasound creates detailed pictures of your coronary arteries. Your provider can see the exact area that needs treatment.
Coronary brachytherapy is a minimally invasive procedure. Your provider uses a catheter (thin, flexible tube) to access the narrowed coronary artery and deliver the local radiation. The procedure only takes about 10 minutes, but you stay at the hospital for several hours.
During the procedure, you can expect:
Most people go home the day of the procedure, but some stay overnight in the hospital. You’ll rest and avoid strenuous activities for a few days. Your provider will prescribe medicine to prevent blood clots.
Coronary brachytherapy can help treat restenosis in people with severe CAD. It’s a treatment option for people with multiple stents, recurring restenosis or high-risk health conditions.
The risks of coronary brachytherapy are the same as any other cardiac catheterization procedure:
The radiation used in brachytherapy is safe. It’s a very carefully controlled dose and it doesn’t travel to any other areas of your body or damage other tissues.
Most people can return to normal activities a few days after the procedure. Talk to your doctor about the specific risks and precautions you should take as you recuperate.
Studies suggest that coronary brachytherapy offers good long-term outcomes for people with complex restenosis, but restenosis can develop again. After treatment, people should continue to follow a heart-healthy lifestyle that includes:
You should call your healthcare provider if you experience:
A note from Cleveland Clinic
Coronary brachytherapy is a treatment for in-stent restenosis (ISR). ISR occurs when scar tissue forms around a stent and causes the artery to get narrow again. Coronary brachytherapy uses radiation to destroy scar tissue and stop it from growing. The treatment isn’t very common, but it may help people with multiple stents, recurring restenosis or chronic health conditions that make them poor candidates for other types of treatment.
Last reviewed by a Cleveland Clinic medical professional on 05/09/2022.
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