Date: 9/10/2001

Community Hospital offers new treatment for clogged arteries

The Community Hospital now offers a bold new treatment that is sparing some heart patients an invasive bypass surgery. The procedure, called vascular brachytherapy, brings together specialists in cardiology and radiation oncology to treat a segment of patients who suffer from recurring artery blockages despite previous treatments.

Approved by the Food and Drug Administration last year, brachytherapy has proven in clinical trials to be highly effective in treating “in-stent restenosis,” a condition in which coronary stents become clogged again with new tissue growth. The therapy involves using low-dose radiation in a minimally invasive procedure to re-open coronary arteries. It is estimated that more than 100,000 patients in the U.S. need treatment for this condition annually. Until now, no effective treatments for in-stent restenosis have been available, other than highly invasive bypass surgery.

“The Community Hospital continually strives to offer patients new therapies that make it easier to undergo treatment for complex conditions. Brachytherapy is just one option in a multitude of cardiac therapies made possible by dedicated physicians and hospital staff who are willing to bring these new procedures to patients in our communities,” said Edward P. Robinson, Administrator of Community Hospital.

The first brachytherapy treatment at Community Hospital was completed successfully in September by cardiologist S. N. Makam, M.D., with assistance by radiation oncologist Andrej Zajac, M.D. The patient was a candidate because his coronary artery stents became clogged repeatedly. A stent is a wire mesh tube that remains inside the artery to keep it open. In this patient’s case, as with nearly 100,000 people across the country, tissue began to grow through the stents over a period of time, restricting blood flow through the artery.

With a system called Beta-Cath, doctors performed an angioplasty (opening the clogged stent with a balloon) inside the artery, and this time through a small catheter, placed tiny radioactive seeds in the clogged area. The seeds provided beta radiation to the site for about three to four minutes to prevent cells from proliferating and re-clogging the stent later. The seeds were then withdrawn from the body and the treatment was completed. The angioplasty plus brachytherapy lasted about an hour and the patient went home the same day.

“The treatment of in-stent restenosis poses a very difficult challenge to cardiologists because the probability of a recurrent stenosis in previously stented patients is an average of 20 percent, and sometimes much higher in some patients, particularly diabetics,” said Makam. “Before this non-invasive treatment was made available, we were having to take a patient to open heart surgery to bypass the clogged artery. Now, we can fix their problems without surgery, they go home the same day, and in most cases, the treated artery will remain permanently open,” Makam said.

In addition, the nature of the radiation provided through the Beta-Cath system enables the brachytherapy treatment to be completed in very little time with minimal radiation exposure to the patient’s healthy tissue, and to medical staff.

“Beta radiation allows the treating physician to stay at the patient’s bedside throughout the procedure. We find this important and significant because it reassures patients that the best possible care is being provided right at the bedside,” said Andrej Zajac, Medical Director of Radiation Therapy at Community Hospital. Zajac added that while radiation oncologists primarily deal with radiation as it relates to cancer, this new therapy is a good example of how physicians work together to bring the latest and best possible treatment options to the community.