ABSTRACT
Restenosis remains a major problem 20 years after the introduction of coronary angioplasty. Pharmacological therapy has generally been disappointing in reducing the incidence of neointimal hyperplasia. Intracoronary brachytherapy is the latest anti proliferative agent that is showing promise in the fight against restenosis. Radiation therapy has been used for decades in the treatment of benign proliferative disorders. Animal studies have consistently demonstrated the efficacy of radiation therapy in inhibiting neointimal hyperplasia. Clinical trials, using different radioactive isotopes and radiation sources, are now showing dramatic reduction in neointimal hyperplasia and restenosis rates following balloon angioplasty and stenting. Intracoronary brachytherapy is beginning to show promise as one of the truly effective agent against neointimal hyperplasia and restenosis.
Restenosis remains a major clinical problem 20 years after the introduction of coronary angioplasty by Andreas Gruentzig in the treatment of coronary artery disease. Recent randomised studies showed a persistent 32% to 57% incidence of angiographic restenosis following successful balloon angioplasty, usually within the first 6 months, despite increased operators proficiency and improved angioplasty equipment.
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