© 2003 by Heart
FEATURED CASE REPORT
Histopathology of coronary in-stent restenosis following 
brachytherapy
1 Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
2 Division of Pathology, Massachusetts General Hospital and Harvard Medical School,
Correspondence to:
Correspondence to:
Dr I F Palacios, Director of Cardiac Catheterization Laboratories, Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Bullfinch 105, Boston, Massachusetts 02144-2696, USA;
ipalacios{at}partners.org
(palacios.igor{at}mgh.harvard.edu)
The histopathology of in-stent restenosis (ISR) following 
brachytherapy is described. Such histology has not been reported previously. An 82 year old man presented with recurrent ISR three months after brachytherapy to an area of ISR within a native circumflex vessel. The recurrent ISR was treated with directional coronary atherectomy; the histopathology of this directional coronary atherectomy specimen is discussed. These histopathological examinations showed abundant extracellular matrix material. Surprisingly, there was a relatively small cellular (myofibroblastic) component, with an absence of endothelial cells and little evidence of active proliferation. ISR after brachytherapy may be a pathologically distinct entity.
Keywords: stents; restenosis; brachytherapy; histology
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This article has been cited by other articles:
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Grewe, P H, Deneke, T, Hanefeld, C, Muller, K-M
(2004). Human coronary morphology after {beta} radiation brachytherapy of in-stent restenosis. Heart
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