Abstract
A percutaneous coronary intervention (PCI) is known to be one of the effective methods for the treatment of coronary artery disease. However, restenosis remains a major limitation of PCI. Recently vascular brachytherapy has been introduced for the prevention of recurrent restenosis following PCI, especially after stenting.We report a case of a 64-year-old man suffering from an acute myocardial infarction due to total occlusion of the proximal right coronary artery (RCA) and critical stenosis in the proximal left circumflex artery (LCX). After successful PCI for RCA occlusion and LCX stenosis, restenosis developed in both arteries on follow-up coronary angiogram. Simple balloon dilation for the proximal RCA edge restenosis, and cutting balloon angioplasty for the instent restenosis, were performed. The follow-up angiogram revealed no restenosis in the RCA or second instent restenosis in the LCX. A vascular brachytherapy using local delivery of 99mTc-HMPAO was performed for this recurrent lesion. A one-year follow-up angiogram, after local radioisotope delivery, revealed a patent stent without restenosis in the LCX.