Case

The late catch-up after beta-radiation therapy using 188Re-MAG3 filled balloon for diffuse in-stent restenosis

- Operator : Seong-Wook Park

The late catch-up after beta-radiation therapy using 188Re-MAG3 filled balloon for diffuse in-stent restenosis
- Operator: Seong-Wook Park, MD, PhD, Korea

A 71-year old female patient was admitted due to exertional chest pain 2 years ago. Her risk factor was hypertension. The patient had been treated with 3.0 x 28 mm Bx stent at the middle segment of the left anterior descending artery (LAD) . Six months after stent implatation, the patient had been readmitted with recurrent chest pain, and received brachytherapy with a 188Re-MAG3 filled-conventional balloon in size and length of 3 x 40 mm (15 Gy at 1 mm depth) for diffuse in-stent restenosis (ISR) (Figure 1) in the middle segment of the LAD after rotational atherectomy (Figure 2: rotational atherectomy, Figure 3: brachytherapy, Figure 4: final result). Six-month follow-up angiography showed that the irradiated lesion had been patent with mild luminal narrowing at the proximal part of the stented segment (arrow of Figure 5). The routine 2-year follow-up study was performed to evaluate the fate of patent irradiated ISR segment at 6 months. It showed that a more decreased luminal narrowing at the proximal part of the in-stent segment (arrow of Figure 6). The patient was asymptomatic with negative treadmill test, thus continued on medical treatment.

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