ABSTRACT
Intracoronary radiation therapy, also called intravascular brachytherapy (IVB), is a novel strategy in the early phase of a routine clinical trial for prevention of restenosis after percutanous intracoronary angioplasty (PTCA) in Europe. The results of major randomized studies in particular the SCRIPPS coronary restenosis prevention trial with a 3-year follow-up, have shown efficacy for VBT. Multiple clinical studies have been completed in the United States, and several brachytherapy systems are now under investigation in Europe. However, recent results from clinical trials have demonstrated important deleterious effects, such as late thrombosis and edge effect. Their mechanisms are still poorly understood and require further investigation. After discussing the main pathophysiological mechanisms by which radiation therapy reduces restenosis, this review describes the different delivery systems and radioactive isotopes and summarizes the main results of clinical studies, especially the side effects of IVB.
