Intravascular brachytherapy physics: Introduction Conference Paper


Author: Amols, H. I.
Editor: Enderle, J. D.
Title: Intravascular brachytherapy physics: Introduction
Conference Title: 22nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Abstract: Coronary artery disease is the most common cause of death in the U.S. Treatment modalities include bypass surgery (>300,000 procedures /year) and Percutaneous Transluminal Coronary Angioplasty (PTCA, >400,000 procedures/year). The latter is less morbid, less expensive, and has an initial 'success' rate of 90%. However, there is a 30-50% restenosis rate within 6 months. The biological mechanisms of restenosis are not fully understood, but it is believed to be caused by neointimal growth and vascular remodeling. The latter can be reduced by implantation of stents (now received by >50% of patients), but stents do not reduce neointimal growth. Intravascular Brachytherapy (IVB) is the use of temporary or permanent radioactive implants to prevent neointimal growth and restenosis following PTCA. Prescribed doses are typically 8-30 Gy to a point 1-2mm from the source, or 0.5-1.5 mm depth into the vessel wall. Because of the steep dose gradients doses to other points may differ significantly from the prescribed dose. The goal of treatment is to deliver a large enough dose to all target cells so as to inhibit new cell growth without exceeding normal tissue tolerance which could lead to vascular necrosis. To date, catheter based IVB, wherein radioactive seeds or wires are temporarily inserted through coronary catheters has been the most common method of IVB. Dose rates are typically >1 Gy/min and large activities of radioisotopes are required (>300 mCi for photon emitters, >20 mCi for betas). The permanent implantation of radioactive stents is an alternative method of IVB.
Keywords: radiotherapy; dosimetry; cardiovascular system; computer simulation; radioisotopes; coronary artery disease; diseases; radiation protection; cardiology; restenosis; implants (surgical); catheters; vascular necrosis; intravascular brachytherapy physics; neointimal growth; percutaneous transluminal coronary angioplasty; vascular remodelling
Journal Title IEEE Engineering in Medicine and Biology Society. Annual International Conference. Proceedings
Volume: 2
Conference Dates: 2000 Jul 23-28
Conference Location: Chicago, IL
ISBN: 1094-687X
Publisher: IEEE  
Location: Chicago, IL
Date Published: 2000-01-01
Start Page: 1573
End Page: 1576
Language: English
PROVIDER: scopus
DOI: 10.1109/IEMBS.2000.898044
DOI/URL:
Notes: Annu Int Conf IEEE Eng Med Biol Proc -- Conference code: 58179 -- Export Date: 18 November 2015 -- CODEN: CEMBA -- 23 July 2000 through 28 July 2000 -- Source: Scopus
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  1. Howard I Amols
    157 Amols