RESUMO
Percutaneous transluminal coronary angioplasty associated with radioactive liquid-filled balloons has demostrated to be useful to inhibit the growth of neointimal tissue. The present study pursued optimizing the relation risk/benefit during a procedure of brachytherapy with 188Re associated to angioplasty. Since the possibility of balloon rupture exists, to increase the security during the treatment different agents such as 188Re-DTPA, 188Re-Citrate and 188Re-EC vs 188ReO4 were evaluated. Dosimetric studies using Mirdose 3, after iv injection to Wistar rats, evaluation of a number of safety requirements in order to estimate radiation dose delivered to operating personnel and absorbed doses estimated by Monte Carlo method (PENELOPE). It is a safe procedure, both for the patient and the working staff; in case of ballon rupture the use of the above mentioned radiopharmaceuticals increases its security. 188Re beta emitor achieves a local dosis, diminishing the dose in healthy tissue.
Assuntos
Animais , Ratos , Doença das Coronárias , Doença das Coronárias/radioterapia , Radioisótopos/administração & dosagem , Radioisótopos/farmacocinética , Rênio/administração & dosagem , Rênio/farmacocinética , Angioplastia Coronária com Balão , Braquiterapia/instrumentação , Distribuição Tecidual , Dosagem Radioterapêutica , Fatores de Tempo , Método de Monte Carlo , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/farmacocinética , Ratos WistarRESUMO
Intracoronary brachytherapy using beta or gamma radiation is currently the most efficient type of therapy for preventing the recurrence of coronary in-stent restenosis. Its implementation depends on the interaction among interventionists, radiotherapists, and physicists to assure the safety and quality of the method. The authors report the pioneering experience in Brazil of the treatment of 2 patients with coronary in-stent restenosis, in whom beta radiation was used as part of the international multicenter randomized PREVENT study (Proliferation REduction with Vascular ENergy Trial). The procedures were performed rapidly and did not require significant modifications in the traditional techniques used for conventional angioplasty. Alteration in the radiological protection devices of the hemodynamic laboratory were also not required, showing that intracoronary brachytherapy using beta radiation can be incorporated into the interventional tools of cardiology in our environment