Description

Coronary artery radiotherapy is a new FDA-approved procedure that uses low-dose radiation to prevent recurring blockages of the coronary arteries. This procedure is an ongoing collaborative effort between UF cardiologists and radiation oncologists who participated in the successful clinical research that led to approval of the treatment device and technique.

This inpatient procedure takes place during angioplasty. More than one million angioplasties are performed annually in the United States. Because they are less costly and less invasive than heart bypass surgery, they are often the treatment of choice for opening arteries clogged with fatty build-up, a condition known as atherosclerosis.

But in up to 40 percent of patients who have angioplasty, the procedure itself can mildly injure the vessel wall, spurring the body to mount an exaggerated healing response that leads to excess scar formation -- and renarrowing of the artery. This renarrowing, known as restenosis, usually leads to recurrent symptoms, and if that occurs patients are likely to need repeat angioplasty.

Procedure

During angioplasty, cardiologists thread a catheter into the narrowed portion of an artery and inflate a small balloon, compressing the fatty build-up against the artery's wall and enlarging the channel where blood flows. Many times they also use a stent, a tiny metal mesh tube crafted from metal that acts as scaffolding inside the artery, to help prop it open.

During coronary artery radiotherapy, the cardiologist performs an angioplasty and the radiation oncologist administers radiation through a device that contains radioactive pellets. The unit, called the Beta-Cath System and manufactured by Norcross, Ga.-based Novoste Corp., is attached to a catheter similar to the one used during routine angioplasty and placed in the treated artery. The pellets radiate the vessel from inside the catheter for two to five minutes and never have direct contact with tissue. The radiation damages the rapidly dividing cells that form scar tissue. Without scar tissue, the stented arteries will allow optimal flow.

The Shands at UF difference

UF physicians at Shands Cardiovascular Center were the first in Florida to perform this new procedure during clinical trials.

Shands Cardiovascular Center was one of 50 sites nationwide to participate in the Beta-CATH and START (Stents and Radiation Therapy) trials, which showed that low-dose radiation administered at the time of angioplasty can prevent the formation of scar tissue. These trials and additional data demonstrating beneficial results for the use of coronary artery irradiation were discussed and presented in the Jan. 25, 2001 issue of The New England Journal of Medicine.

Through a two-year participation in these clinical trials, the UF cardiovascular teams at Shands at UF and Shands Jacksonville have the most extensive experience in Florida with this innovative and effective therapy.

Multidisciplinary team

Richard A. Kerensky, M.D.
UF College of Medicine associate professor of Medicine, Division of Cardiology, director of Interventional Cardiology and the Shands at UF Cardiac Catheterization Laboratory

Richard Kerensky, M.D., is recognized for his expertise in cardiovascular diseases. His clinical interests include acute myocardial infarction, cardiac catheterization, coronary angioplasty, directional coronary atherectomy, mitral balloon valvuloplasty, coronary stenting, coronary ultrasound, CAD in women.

Kerensky, a UF Medical School graduate, completed his residency in Internal Medicine and a fellowship in Cardiology at Bowman Gray - Wake Forest University.

Robert A. Zlotecki M.D., Ph.D.
UF College of Medicine associate professor of medicine, Department of Radiation Oncology

Robert Zlotecki, M.D., Ph.D., is recognized for his expertise in the field of Radiation Oncology. His clinical interests include genitourinary cancer, sarcomas and pulmonary malignancy.

Zlotecki completed his residency in Radiation Oncology at Harvard Medical School. He completed a research fellowship at the Michigan Heart Association, University of Michigan and American Cancer Society, as well as fellowship in Clinical Pharmacology at Upjohn.

Karen M. Smith, M.D.
UF College of Medicine assistant professor of Medicine, Division of Cardiology

Karen Smith, M.D., is recognized for her expertise in cardiovascular diseases.

Smith completed her residency in Internal Medicine and a fellowship in Cardiology and Interventional Cardiology at North Carolina Baptist Hospital.

The team also includes Brad Green, technical director of the Cardiac Cath Lab, Shands at UF; Carla Schmidt, Cardiac Cath Lab lead technologist and clerical supervisor; Gwen Thomas, RN; and Nancy Carmichael, PA-C, among others.

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To make a new patient appointment or find out more information about heart care services offered at Shands at the University of Florida, please call 352.265.0943 .

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