We sought to demonstrate that brachytherapy reduces coronary spasm in refracto ry and highly symptomatic variant angina. In some patients with variant angina d ue to extensive vasoconstriction, intensive drug therapy ...We sought to demonstrate that brachytherapy reduces coronary spasm in refracto ry and highly symptomatic variant angina. In some patients with variant angina d ue to extensive vasoconstriction, intensive drug therapy fails to sufficiently r elieve symptoms. In 18 patients with frequent angina episodes despite triple ant i anginal therapy, coronary spasm was induced by intracoronary acetylcholine (A Ch) infusion. Five patients had spasm in a second vessel. Intracoronary radiatio n(20 Gy) was applied to vasospastic segments using a beta emitting (32P) wire s ource centered within a Galileo balloon. Parameters of vessel function before an d after brachytherapy were investigated. Before brachytherapy, artery diameters decreased(p< 0.0001) from 2.8±0.4 mm to 1.0±0.4 mm for the first vessels and f rom 3.1±0.3 mm to 1.0±0.2 mm for the second vessels. After brachytherapy (143 ±106 and 80±52 days for first and second vessels, respectively), ACh induced vasoconstriction was significantly reduced. The ACh induced changes in artery d iameter before and after brachytherapy were -1.5±0.5 mm and -0.5±0.3mm(p< 0. 0001) for the first vessels and -1.4±0.3 mm and -0.4±0.2 mm (p< 0.01) for th e second vessels, respectively. In non irradiated spastic vessels, ACh induced vasoconstriction remained unchanged (e.g., -1.7±0.6 mm, -1.6±0.3 mm, and - 1.5±0.5 mm for second vessels, at first investigation, first follow up, and im mediately before brachytherapy, respectively). Angina frequency decreased from 1 5.6±6.0 to 2.2±2.4 angina episodes/week(p< 0.001) in treated patients. Brachyt herapy is a potential therapy in patients with highly symptomatic variant angina .展开更多
文摘We sought to demonstrate that brachytherapy reduces coronary spasm in refracto ry and highly symptomatic variant angina. In some patients with variant angina d ue to extensive vasoconstriction, intensive drug therapy fails to sufficiently r elieve symptoms. In 18 patients with frequent angina episodes despite triple ant i anginal therapy, coronary spasm was induced by intracoronary acetylcholine (A Ch) infusion. Five patients had spasm in a second vessel. Intracoronary radiatio n(20 Gy) was applied to vasospastic segments using a beta emitting (32P) wire s ource centered within a Galileo balloon. Parameters of vessel function before an d after brachytherapy were investigated. Before brachytherapy, artery diameters decreased(p< 0.0001) from 2.8±0.4 mm to 1.0±0.4 mm for the first vessels and f rom 3.1±0.3 mm to 1.0±0.2 mm for the second vessels. After brachytherapy (143 ±106 and 80±52 days for first and second vessels, respectively), ACh induced vasoconstriction was significantly reduced. The ACh induced changes in artery d iameter before and after brachytherapy were -1.5±0.5 mm and -0.5±0.3mm(p< 0. 0001) for the first vessels and -1.4±0.3 mm and -0.4±0.2 mm (p< 0.01) for th e second vessels, respectively. In non irradiated spastic vessels, ACh induced vasoconstriction remained unchanged (e.g., -1.7±0.6 mm, -1.6±0.3 mm, and - 1.5±0.5 mm for second vessels, at first investigation, first follow up, and im mediately before brachytherapy, respectively). Angina frequency decreased from 1 5.6±6.0 to 2.2±2.4 angina episodes/week(p< 0.001) in treated patients. Brachyt herapy is a potential therapy in patients with highly symptomatic variant angina .
