Abstract
In the present issue of Circulation , Drs Teirstein and King1 and Waksman and Weinberger2 provide a chronology for the evolution in concept and practice of vascular brachytherapy (VBT). The documentation for durable efficacy of VBT in suppressing recurrent in-stent restenosis (ISR) has been provided by multiple randomized controlled clinical trials. The importance of extending the length of radiated arterial segments well beyond the zone of procedural endoluminal injury has become evident. Similarly, the relative clinical and angiographic safety of VBT (versus conventional therapies for ISR) has been demonstrated, and specific procedural as well as adjunctive pharmacological protocol modifications have evolved. These have included the avoidance of restenting and the prolonged administration of clopidogrel therapy, which have collectively effectively eliminated the previously alarming issue of late thrombosis after VBT. Finally, an effective …
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