Lumen Centering Versus IVUS-Probe Centering of Gamma Sources: Retrospective Evaluation of Doses to Intima and Adventitia for Intravascular Brachytherapy Cases

摘要

Intravascular brachytherapy (IVBT) in the treatment of in-stent restenosis (ISR) using gamma or beta sources delivered at the time of angioplasty has been proven to be effective in preventing restenosis induced by intcrventional recanulazation procedures.1 Long-term follow-up results showed continued benefit of IVBT, with improvement in target lesion revascularization and event-free survival.2 Among the catheter-based systems, some delivery1 catheters are lumen-centered, while others are not. Despite the success of IVBT in treating ISR, the debate regarding the potential benefit of lumen-centering of radioactive sources in the delivery- of IVBT is still ongoing. A common approach of dosimelric evaluation has been based on the assumption that the radioactive sources may be at the center of the IVUS probe in individual image slices. Dosimetric evaluations based on IVUS-probe centered configurations have been reported for Cordis Ir-192 ribbon system.