Brachytherapy for Coronary Artery Restenosis

Yale New Haven Hospital offers brachytherapy to treat coronary artery restenosis, which is excessive scar tissue that has developed inside stents previously implanted to treat coronary artery disease (CAD). The incidence of scar tissue developing inside a stent is about 10 percent. 

If patients with a coronary stent experience chest pain or angina resulting from their CAD, restenosis may be present. An angiogram (cardiac catheterization) is performed to check for scar tissue. Depending on amount of scar tissue, brachytherapy, a type of radiation therapy, may be offered as a treatment option to prevent scar tissue from forming again. Both an interventional cardiologist and therapeutic radiologist perform brachytherapy.

Before brachytherapy, scar tissue is broken up and cleared from the treated area. A specialized brachytherapy catheter is placed within the site of the former coronary blockage. The catheter delivers radioactive sources to the treatment site to reduce the types of cells that may grow and could trigger restenosis. From 16 to 24 radiation sources, each about the size of a grain of rice, are used for the procedure. Once the dosage is given, typically within about five minutes, the radiation sources are removed from the catheter and catheter is then removed from the patient. Patients go home the same or next day after treatment.