Brachytherapy

From Bay Area Structural Heart Wiki
Revision as of 18:23, 6 December 2021 by Suddemj (talk | contribs)

Brachytherapy utilizes a sealed-source beta emitter placed in a coronary artery to treat persistent in-stent restenosis. Expect multiple complex PCI techniques to be employed: Laser, OCT, Shockwave, and Rotablator are common elements of this procedure.

DRAFT

Checklist for Coronary Brachytherapy (IVBT)

Scheduling:

1. Ensure Dr. Benjamin Romick or Dr. David Daniels availability

  • Fridays preferred dates


2. Coordinate with Radiation Oncology:  Radiation oncologist will then coordinate with Physics team

  • John Lee, MD – Director of Radiation Oncology
    • Mobile: 415-307-1811
    • Email: LeeJY@sutterhealth.org
  • Roy Abendroth, MD – Radiation Oncologist
    • Mobile: 510-693-9885
    • Email: AbendR@sutterhealth.org


3. Coordinate with Best Vascular representative (Craig Reed 1st contact)

  • Craig Reed – Best Vascular
    • Mobile: 470-514-6788
    • Email: creed@teambest.com
  • Chris Sherman
    • Mobile: 770-329-1696
Attendance of the Beta Cath rep for cases is optional, though preferable


4. Reserve use of OCT & Contact Abbott/St. Jude Vascular Rep (optional)

  • Quinten Beckmann
    • Mobile: 415-271-9476
    • Email: Quinten.beckmann@abbottvascular.com


5. Reserve the Spectranetics Laser generator for all IVBT cases

Coordinate with EP to avoid conflict with lead extraction days

6. Shockwave lithotripsy device (selected cases) – contact Shockwave Rep

  • Joe Narcisse
    • Mobile: 925-548-3666


7. Ensure prior authorization achieved on outpatients

Equipment List for Procedure (assess inventory week of procedure)

Note Protip: Ensure SyncVision is on and in device detection mode!

Brachytherapy Mayo Setup
  • Routine PCI equipment (> 6 Fr guides; 0.014 Coronary guidewires; NC balloons; IVUS)
  • Guideliners (7&8 Fr – Beta Rail will not deliver through 6 Fr Guideliner)
  • Novoste Beta Rail (blue box in CCL 1 & 6)
    • Includes syringes and sterile bag
  • Share bowl from pack or open a TAVR bowl
  • 3/4 drape for mayo stand
  • Spectranetic ELCA Vitresse RX 0.9 mm; 1.4mm & 1.7 mm catheters
  • Dragonfly OCT catheters
  • 3.5 x 40mm & 4.0 x 40mm Shockwave balloons
  • Atherectomy devices – Roto Pro burrs various sizes; CSI Diamondback
  • High pressure indeflator to 30 atm (the default Abbott indeflator)
  • Sterile Water for Beta Rail Delivery Catheter


Approved: MD Name MM/YY