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Histopathology of coronary in-stent restenosis following γ brachytherapy
  1. H C Lowe1,
  2. M Mino2,
  3. E J Mark2,
  4. B D Mac Neill1,
  5. I F Palacios1,
  6. S L Houser2
  1. 1Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
  2. 2Division of Pathology, Massachusetts General Hospital and Harvard Medical School,
  1. 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)

Abstract

The histopathology of in-stent restenosis (ISR) following γ brachytherapy is described. Such histology has not been reported previously. An 82 year old man presented with recurrent ISR three months after γ 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 γ brachytherapy may be a pathologically distinct entity.

  • stents
  • restenosis
  • brachytherapy
  • histology

https://doi.org/10.1136/heart.89.1.11

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