Patient: Cardiac Disease: Frequently Asked Questions
What is Angioplasty?
Angioplasty involves the inflation of a balloon in a narrowed area of the coronary artery. The balloon compresses the plaque (material causing the narrowing) against the wall of the artery. A successful angioplasty procedure opens the narrowing and improves blood flow through the artery. Stents, which are small, wire, mesh-like tubes, may be placed at the time of the angioplasty to help keep the artery open. Both angioplasty and stenting cause a small injury to the wall of the artery that usually heals within 3 to 9 months.
What Causes In-Stent Restenosis?
In-stent restenosis is the re-closure of a coronary artery following stent placement, and is due to the overgrowth of scar tissue during the healing process. In-stent restenosis requires angioplasty or an additional coronary intervention to re-open the artery.
What is Vascular Brachytherapy?
Vascular Brachytherapy is a procedure designed to reduce the reoccurrence of in-stent restenosis that may occur after stent placement. Several clinical trials have shown that Vascular Brachytherapy following an angioplasty procedure for in-stent restenosis significantly reduces the need for additional procedures. Vascular Brachytherapy uses radiation within the previously narrowed area of the stent to reduce scar tissue formation during the healing process. The radiation is delivered to the area to be treated for a specified amount of time, following the angioplasty procedure.
What is the Beta-Cath™ System?
The Beta-Cath™ System is designed to deliver low penetrating Strontium 90 beta radiation to the treatment site following angioplasty for in-stent restenosis. The use of Strontium 90 beta radiation with its low penetration allows clinicians to stay in the room with the patient during the short treatment. The Beta-Cath™ System has been used very successfully to treat thousands of patients worldwide.
How is the treatment with the Beta-Cath™ System performed?
You will be taken to the Cardiac Cath Lab where the angioplasty or additional coronary intervention may be performed to open the blocked artery. After the procedure is completed, the Beta-Cath™ Delivery Catheter replaces the angioplasty catheter in the previously narrowed area. Once this catheter is in place, the Strontium 90 radiation source will be delivered to the treatment site through the catheter and will remain in place for approximately 3 to 4 minutes. When the treatment is completed, the radiation sources and the catheter are removed. Treatment with the Beta-Cath™ System adds less than 10 minutes to the total treatment time and and no radiation remains in the body.
What will the Beta-Cath™ System treatment feel like?
You should not feel any sensation as a result of treatment with the Strontium 90 radiation. As with any interventional procedure, you may feel some chest discomfort as the catheter is placed within your narrowed coronary artery. This discomfort is temporary and is relieved when the catheter is removed.
What are the risks of Beta radiation?
Although there are potential risks associated with radiation of the coronary arteries, clinical trials with the Beta-Cath™ System have shown minimal adverse effects up to 4 years after treatment. Other risks involved are the same that apply to other procedures in the Cardiac Cath Lab and may include: heart attack, thrombosis (blood clots in the artery), emergency surgery, stroke or death. Long-term adverse effects of beta radiation delivered to the coronary arteries are unknown. The dose of radiation to the body is minimal - less than a chest x-ray and much less than that received during angioplasty from fluoroscopy.
What are the treatment alternatives to Vascular Brachytherapy?
You should discuss with your physician adjunctive or alternative therapies involving diet, exercise, and/or drug therapy. However, progression of coronary artery disease may require further treatment including additional balloon angioplasty, additional stent placement, or possible open heart surgery.
What are the contraindications and precautions?
The contraindications and precautions that apply to angioplasty or other interventional procedures also apply to Vascular Brachytherapy treatment. Inability to tolerate anti-platelet therapy or anticoagulation is a contraindication when a new stent is placed. Special consideration should be given to women who are pregnant or suspect pregnancy.
How long is the hospital stay?
Treatment with the Beta-Cath™ System will add approximately 10 minutes to your procedure time in the Cardiac Cath Lab. Your hospital stay should be the same as for an angioplasty or stent procedure.
Will additional medication be needed?
Based on your physician’s judgment regarding the best course of treatment for you, additional medication may be required. Your physician will discuss this with you before you are discharged from the hospital.