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Saint Barnabas Medical Center Adds Intracoronary Brachytherapy to Cardiac Services -- New Help for Stent Patients Whose Arteries Have Re-narrowed LIVINGSTON, NJ -- The HEART HOSPITAL of New Jersey at Saint Barnabas Medical Center is one of only a few hospitals in the state to provide a breakthrough radiation technique for cardiac patients whose arteries have re-narrowed following angioplasty – a heart procedure that opens a blocked artery and helps prevent heart attacks “When I heard it was effective 80 percent of the time, I thought it was a great idea,” said Joan Perrine of Chatham and Martha’s Vineyard who recently went through the procedure after an angiogram found that her artery was closing up following a previous angioplasty “I had hoped that I would be one of the lucky majority who didn’t have a problem with an artery closing up again,” she said. “But that wasn’t the case.” According to Sabino Torre, M.D., an interventional cardiologist at Saint Barnabas Medical Center who treated Ms. Perrine, a successful angioplasty opens the narrowing and improves blood flow through the artery. However, in an average 25 to 30 percent of these cases, the stented coronary artery re-narrows with new tissue growth, requiring repeat angioplasty to re-open the artery The chance of restenosis is directly related to the size of the artery and the stent, a small stainless steel mesh tube designed to prevent elastic recoil of the artery back to its narrowed state by propping it open. There tends to be less re-narrowing when a shorter stent has been placed within a bigger vessel, and conversely, more scar tissue blockage when a longer stent has been placed within a shorter vessel In native coronary arteries (those with which one is born) restenosis predictably occurs between 60 days and 90 days. With vein grafts (bypass vessels placed by surgeons) re-narrowing tends to occur more slowly, from three to nine months. If restenosis has not occurred by six months, it is considered unlikely to happen Intracoronary brachytherapy is a procedure designed to reduce the reoccurrence of in-stent restenosis. The Food and Drug Administration (FDA) recently approved the use of both beta and gamma radiation systems after several clinical trials demonstrated that intracoronary brachytherapy following angioplasty for in-stent restenosis significantly reduced the need for repeat procedures “The scar tissue is composed of rapidly proliferating cells that line the vessel,” said Dr. Torre. “Radiation is an ideal tool to eliminate the scar tissue proliferation because it works best upon rapidly growing cells.” The system being used at Saint Barnabas is Beta-Cathä by Novoste, the first intracoronary beta radiation device to receive FDA approval. Beta-Cathä is actually two systems: a catheter delivery system and a shielded hydraulic pump containing tiny radioactive seeds that emit beta radiation. This system was selected because beta radiation results in not only shorter procedure time but also lesser radiation exposure for both the patient and the staff. The exposure is three to four minutes as opposed to 20 minutes, enabling doctors and nurses to remain at the patient’s side The procedure is performed in the cardiac catheterization laboratory at Saint Barnabas Medical Center by a multidisciplinary team including an interventional cardiologist, radiation oncologist and physicist. The interventional cardiologist first performs a diagnostic catheterization and angiogram and may then perform an angioplasty or additional coronary intervention to open the re-blocked artery “Despite many trials of pharmacological agents and other catheterization technology, the problem of restenosis has been very persistent,” said Dr. Torre. “Intracoronary brachytherapy is backed by data from thousands of patients in several large trials and is the first clear winner with regard to reducing in-stent restenosis.” For more information about intracoronary brachytherapy, please call The Heart Hospital of New Jersey at Saint Barnabas Medical Center at 1 (888) 8-HEART-1 [ top ] |
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