After a stent placement, blood vessels can become blocked, and this can be prevented with Coronary brachytherapy. There are risks to this therapy, which is very effective in preventing additional obstructions.

This article gives a step-by-step overview of what to expect if you need coronary brachytherapy, as well as information on the risks and benefits of this procedure.

Coronary artery disease (CAD) is a condition that develops slowly throughout your life. The risk of developing CAD increases if a person has a family history of the condition. Diet and lifestyle choices are also risk factors.

With CAD, fats like cholesterol and other minerals build up in your blood vessels and form hard coatings called plaque. Over time, plaque can build up to the point where it narrows the vessel, restricting the flow of blood to your vital organs.

In some cases, pieces of the plaques can break off, causing serious problems like a heart attack or stroke.

The most common treatment when blood vessels become blocked with plaque from CAD is to place a stent, which is a small device that helps keep blood vessels open.

While these stents are usually coated with medications designed to reduce the formation of new plaques or scar tissue, blood vessels treated with stents can be complicated by restenosis, or a repeated narrowing of the blood vessel.

There are two ways to treat restenosis.

  • The first drug-coated stent was placed through the second.
  • Radiation therapy inside the blood vessel is used to clear the blocked arteries.

Brachytherapy is a form of internal radiation used to treat a number of conditions, including cancer. With this therapy, tiny particles of radiation therapy in the form of capsules or granules are used to destroy things like tumors or other growths and blockages.

Radiation particles are used to destroy tumors when brachytherapy is used. The procedure has a few more steps.

Before your procedure is scheduled, you will have a meeting with your doctor or medical team to discuss your condition and possible treatments. If you are recommended for coronary brachytherapy, your medical care team should talk to you.

  • Why do you need brachytherapy?
  • how the procedure will be performed
  • Who will do the procedure?
  • How should you prepare?
  • What to expect during your brachytherapy.
  • How you will feel after that?
  • What will be the recovery like?

On the day of your procedure, you should leave your valuables at home, wear comfortable clothing, and have someone drive you to and from the medical facility.

While full anesthesia isn’t required for coronary brachytherapy, some level of sedation or anesthetic is used with most types of brachytherapy. You may be able to go home the same day the procedure is done, but you should plan to rest for a few days.

The steps below are general and will be used during your brachytherapy. Your doctor may perform a procedure on you based on your condition.

  • You will be taken to a treatment area.
  • You will be asked to wear a hospital gown.
  • The procedure that is about to be done, the steps that will be taken, any medications that are to be given, and why the procedure is being performed will be confirmed by your medical team.
  • You will lie on the table when the procedure is about to begin. You should be given some form of anesthesia or sedation to help you feel better during the procedure.
  • A flexible catheter — similar to what is used for a cardiac catheterization — that can reach the blockage is inserted into your body through an artery close to the blocked area, usually in the wrist or groin.
  • The catheter will open the blocked vessel once it is in place at the restenosis.
  • After an opening is formed, radiation will be delivered to the area to remove scar tissue and prevent it from forming.
  • The procedure is over when the catheter is removed and the radiation is delivered for 3 to 5 minutes.

You should be able to go home on the same day after you are monitored for a short time. You should limit your physical activity for a few days after the procedure to prevent any problems.

The procedure is done to clear the blocked arteries used to treat the disease.

Restenosis occurs in roughly 20% to 50% of people whose CAD was treated with stents alone. Whether restenosis occurs is typically based on the number of stents used, whether they’re multilayered, and whether they’re bare metal or drug-eluting.

Since the introduction of medication-coated stents to reduce the formation of new obstructions, restenosis has decreased, but these are still occuring. Once the stents have been replaced more than once, they are usually used for coronary brachytherapy.

This procedure is very effective at preventing new obstructions.

Coronary brachytherapy is highly effective at treating and preventing restenosis. According to one study published in 2017, immediate benefits were seen in nearly every patient (97%) who had this procedure, and most were able to go home the same day or within a day of treatment.

Although restenosis occurred in some people after coronary brachytherapy (up to 42% after 3 years), serious complications like heart attack or blood clots were rare. As with any invasive procedure, there is also the possibility of infection at the site of catheter insertion or reactions to medications like sedatives or anesthesia.

Discuss any problems you have had with your doctor about any medication allergies you may have and any other issues you may have.

A narrowing of your blood vessels can cause problems.

If the same vessels become blocked repeatedly, additional treatments may be needed, even if they are the first choice.

Coronary brachytherapy is used to clear blocked stents. This therapy clears scar tissue and can help prevent restenosis, which is when a blood vessel is blocked.