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Inhibition of Arterial Restenosis Following Balloon Angioplasty

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Radiopharmaceuticals for Therapy

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Abstract

The availability of effective methods to treat and manage the restenotic phenomena which usually occur over time following arterial balloon angioplasty is a continual goal of interventional cardiology and radiology. Many technologies have been evaluated and many are still under investigation. The use of appropriately anatomically focused doses of ionizing radiation from intra-arterial sources is an effective strategy for inhibition of the smooth muscle cell proliferation which characterizes the restenotic milieu. Use of solid radioactive source is practiced in radiation oncology/interventional cardiology, while the use of unsealed radioactive sources (i.e., radiopharmaceuticals) has traditionally represented a partnership between nuclear medicine and interventional cardiology. This technology involves the use of radioactive liquid-filled balloons for radiation dose delivery to the vessel wall post angioplasty and has been referred to as intravascular radiation therapy (IVRT). In addition, stents coated with radioisotope agents have been evaluated, but the most effective approach has been the post-balloon angioplasty use of angioplasty balloons filled with beta-emitting radioactive liquid sources which was pioneered with the 188Re. Although this technology has worked very well in the coronary vessels, the introduction and current wide use of alternative nonradiation-based technologies with drug-eluting stents (DES) has overshadowed the use of radioisotopes for this application. However, the introduction of 188Re-liquid-filled balloons for restenosis therapy following angioplasty of the peripheral vessels represents a recent rejuvenation of this technology. This chapter reviews the basic concepts using radioactive liquid-filled balloons for arterial restenosis therapy.

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Authors and Affiliations

  1. Nuclear Security and Isotope Division, Oak Ridge National Laboratory, OAK RIDGE, USA

    F. F. (Russ) Knapp

  2. Isotope Production and Applications Division, Bhabha Atomic Research Centre, Mumbai, India

    Ashutosh Dash

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  1. F. F. (Russ) Knapp
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Knapp, F.F.(., Dash, A. (2016). Inhibition of Arterial Restenosis Following Balloon Angioplasty. In: Radiopharmaceuticals for Therapy . Springer, New Delhi. https://doi.org/10.1007/978-81-322-2607-9_15

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  • DOI: https://doi.org/10.1007/978-81-322-2607-9_15

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