What is coronary brachytherapy?

• A. Utilizes beta and gamma emitters placed in stent
• B. Uses laser to disrupt plaque
• C. Relies on balloon inflation to compress plaque
• D. Involves external beam radiation to the heart

Answer: (A)

Coronary brachytherapy delivers focused radiation directly to the artery wall at the treatment site to prevent restenosis after a PCI. A radioactive source emitting beta and gamma radiation is placed in or right next to the artery segment, often via a specialized stent or catheter. The radiation harms the proliferating smooth muscle cells in the neointima, reducing neointimal hyperplasia and lowering the chance of the vessel re-narrowing. This localized approach is distinct from other methods: lasers disrupt plaque with energy, balloon angioplasty relies on mechanical compression, and external beam radiation treats the chest from outside the body rather than delivering radiation to a specific coronary segment. Historically, coronary brachytherapy aimed to curb restenosis before drug-eluting stents became widespread.