Brachytherapy

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.

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: [[1]]
  • Email: LeeJY@sutterhealth.org
  • 7.5 glove size

• Roy Abendroth, MD – Radiation Oncologist
  • Mobile: [[2]]
  • Email: AbendR@sutterhealth.org

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

• Craig Reed – Best Vascular
  • Mobile: [[3]]
  • Email: creed@teambest.com

• Chris Sherman
  • Mobile: [[4]]

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: [[5]]
  • 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: [[6]]

7. Ensure prior authorization achieved on outpatients

Equipment List for Procedure (assess inventory week of procedure)

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

---