• 대한핵의학회:학술대회논문집
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• 2001.05a
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• pp.24-34
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• 2001

Restenosis remains a major limitation of percutaneous coronary interventions. Numerous studios including pharmacological approaches and new devices failed to reduce the restenosis rate except coronary stenting. Since the results of $BENESTENT^{1)}\;and\;STRESS^{2)}$ studies came out, coronary stenting has been the most popular interventional strategy in the various kinds of coronary stenotic lesions, although the efficacy of stenting was shown only in the discrete lesion of the large coronary artery. The widespread use of coronary stenting has improved the early and late outcomes after coronary intervention, but it has also led to a new and serious problem, e.g., in-stent restenosis. Intravascular radiation for prevention of restenosis is a new technology in the field of percutaneous coronary intervention. Recent animal experiments and human trials have demonstrated that local irradiation, in conjunction with coronary interventions, substantially diminished the rate of restenosis. This paper reviews basic radiation biology of intracoronary radiation and its role in the inhibition of restenosis. The current status of intracoronary radiation therapy using Re-188 liquid balloon is also discussed.

• 대한핵의학회:학술대회논문집
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• 1999.05a
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• pp.209-221
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• 1999

Coronary restenosis is still regarded as Achilles' Hill of interventional cardiology despite relentless efforts of many investigators. Recent experimental and clinical studies have suggested that both gamma and beta radiation can reduce restenosis after angioplasty. Currently, intracoronary brachytherapy for the prevention of restenosis has become a new evolving treatment modality in interventional cardiology. This report discusses a physical aspect of gamma and beta radiation, initial clinical results and delivery systems used in intracoronary brachytherapy. We shall take a brief overview of methods and their advantages in intra-coronary brachytherapy. Future work should provide further insight for the best way of treating restenosis.

• 대한핵의학회:학술대회논문집
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• 1999.05a
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• pp.228-241
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• 1999

Percutaneous coronary angioplasty is well established therapeutic modality in the management of coronary artery disease. However, the high restenosis rate of 30 to 50% limits its usefulness. The principal mechanism of restenosis, intimal hyperplasia, is the proliferative response of vessel wall to injury, which consists largely of smooth muscle cells. A large body of animal investigations and a limited number of clinical studies have established the ability of ionizing radiation to reduce neointimal proliferation and restenosis rate significantly. Human studies have been reported that intravascular radiation after first restenosis inhibits a second restenosis. Encouraged by these reports, we are also conducting a double blind, placebo-controlled, randomized trial to evaluate this new therapeutic modality in patients with coronary artery stenosis. The objective of our trial is to determine the safety and efficacy of catheter-based solutional beta emitting radioisotope system in preventing restenosis after angioplasty. This review describes the vascular brachytherapy systems and isotopes that have been utilized in the initial clinical trials performed in this area of post PTCA coronary restenosis. The results of many worldwide ongoing clinical trials will determine whether this new technology will change the future practice of vascular intervention.