For Immediate Release
September 14, 2001
Contact: Maria E. Ramos
(219) 865-2141, ext. 45321
Maria.Ramos@ssfhs.org

Hammond/Dyer - - Cardiovascular brachytherapy – beta radiation therapy – is not meant to heal an “achy breaky heart,” but it will prevent a previously stented artery from renarrowing. The procedure, performed for the first time in Northwest Indiana at Saint Margaret Mercy Healthcare Centers on Aug. 17, offers glowing promise of stunting the occurrence of restenosis.

It is estimated that more than 100,000 patients in the United States are treated with a stent placement for a narrow coronary artery (the artery supplying the heart muscle) to prevent heart attacks. However, 15 percent to 30 percent of patients experience repeat narrowing or restenosis after stent placement. Until now, no effective treatment has been available other than coronary bypass surgery, which can be expensive and require a long recuperation period.

Dr. Narayan Mulamalla, medical director of Saint Margaret Mercy’s Cardiovascular Services and a board-certified cardiologist, and Dr. Parag Doshi, also a board-certified cardiologist, performed three successful cardiovascular brachytherapies on Aug. 17 with patients returning home the next day.

“This is state-of-the-art technology. There are no additional risks involved with this procedure as compared to balloon angioplasty or stent placement,” said Dr. Mulamalla. “This procedure substantially reduces the risk of renarrowing of the artery, thereby reducing the need for additional procedures with associated risks and costs.”

Dr. Doshi agrees: “The patients are anxious to avoid multiple procedures at all costs. Because the radiation exposure involved is minimal, there are no adverse systemic effects.

“I will be watching on-going studies closely, as indications are expanded to include blockages in arteries before stent placement,” Dr. Doshi added.

Dora Slupski, manager of North Campus Cardiovascular Services, explained: “The body’s natural reaction to injury is to form a scar. Angioplasty or placement of a stent may be perceived by the body as an injury, thereby prompting tissue growth, resulting in renarrowing of the arteries.

“Immediate radiation after opening up the narrow artery diminishes cell growth,” Slupski added. “In and of itself, the radiation does not make the blockage go away, it simply prevents cell growth, thereby, preventing renarrowing.”

Results from the START (STents And Radiation Therapy) Trials conducted by Novoste – developer of the Beta-Cath™ System used at Saint Margaret Mercy to deliver the radiation – demonstrate that the procedure significantly reduces the frequency of restenosis and additional procedures to re-open stented coronary arteries. Patients treated with beta radiation had a 34 percent lower incidence of repeat revascularization procedures than patients who did not receive the radiation treatment. In addition, patients receiving this treatment method had a 31 percent lower rate of major adverse cardiac events than those in the placebo group.

At Saint Margaret Mercy, cardiovascular brachytherapy is a team approach involving cardiologists, radiation oncologists and a medical physicist from the Oncology Center. The cardiologist identifies the problem and exact location, measures the length of the lesion and size of the vessel, places the delivery catheter across the lesion and verifies it is in proper place. Then radiation oncologist Dr. Urmi P. Kalokhe, or medical physicist Dr. Renate Muller-Runkel connects the delivery catheter containing the radiation source and injects the beta radiation to the angioplasty site.

For approval to perform cardiovascular brachytherapy, Dr. Muller-Runkel, who also is Saint Margaret Mercy’s Radiation Safety Officer, applied for amendments to the hospital’s existing Nuclear Regulatory Commission license. She verifies dose calculations, maintains quality assurance assessment information, and is responsible for the safety of those in the Cath Lab.

The new procedure is a regional effort, as well, with physicians from Saint Margaret Mercy’s sister hospitals – St. Anthony Medical Center in Crown Point and St. Anthony Memorial Health Centers in Michigan City – participating in staff training sessions.

For more information on cardiovascular brachytherapy, contact Cardiovascular Services at (219) 933-2120.