Some patients who have stents to open blocked coronary arteries get in-stent restenosis, which means the artery becomes narrow again. If this happens, your doctor will talk to you about treatments used to reopen the artery.
If you have in-stent restenosis more than 1-2 times, your doctor may talk to you about brachytherapy (also called vascular brachytherapy or VBT). Brachytherapy helps prevent the growth of too much tissue over the treated area of the artery as it heals.
Brachytherapy is usually done along with a balloon procedure or laser atherectomy (a laser is used to clear the blockage in the artery). Your doctor may also place stents in the artery if these treatments don’t work well enough.
Is Brachytherapy Right for Me?
Your doctor will carefully consider the size of your narrowed artery and blockage, your history and details of restenosis, the number of stents you have, and your personal risk of restenosis. This assessment, along with tests to get more information about your condition, will help your doctor decide if brachytherapy is a good treatment option for you. In general, brachytherapy is an ideal treatment if your restenosis is caused by extra scar tissue.
Brachytherapy is a coronary interventional procedure that involves radiation. The radiation stuns or kills some of the cells that cause restenosis. An interventional cardiologist works closely with a radiation oncologist and radiation physicist to make sure you get the exact amount of radiation needed.
Brachytherapy is much like an angioplasty or stent procedure. Your cardiologist will use a long, thin tube called a catheter that is inserted into your artery through a small incision. The catheter is guided to the blocked area, and a tiny balloon (angioplasty) or cutting device (atherectomy) is used to clear the area.
Another catheter is used to place a radioactive ribbon across the blockage. Beta radiation is delivered to the area for 5 to 10 minutes, then the catheter is removed.
Risks / Benefits
There are risks with all medical procedures. Your doctor will talk to you about the risks and benefits of brachytherapy. If you have had radiation as treatment for breast cancer or cancer in your chest area, you will not be a candidate for brachytherapy.
It is hopeful that brachytherapy will let patients go longer without restenosis. In studies to see how well brachytherapy works over a long period of time, patients who had restenosis after getting bare metal stents had improved long-term outcomes. The research involving brachytherapy for patients who had restenosis after getting drug-eluting stents is ongoing.
Recovery and Outlook
Your healthcare team will give you details about your recovery. For more information, click here: Recovery after coronary interventional procedures. You will need to take medication to prevent blood clots. Your doctor will talk to you about the best type of medication for you.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy