Prostate brachytherapy seed migration to the right coronary artery associated with an acute myocardial infarction
Prostate brachytherapy seed migration to the right coronary artery associated with an acute myocardial infarction
复制标题
DOI：
10.1016/j.brachy.2006.08.004
复制
发表时间：
2006-10-01
期刊：
影响因子：
1.9
通讯作者：
Foster, Gary P.
中科院分区：
文献类型：
--
作者：
Zhu, Alan X.;Wallner, Kent E.;Foster, Gary P.
目的：我们报告一例前列腺近距离放射治疗种子迁移到冠状动脉（RCA）合并急性心肌梗死（AMI）。方法与材料：一名69岁男性于2003年10月被诊断为前列腺腺癌II期（T1cN0M0）。2003年12月15日经直肠超声引导下行经皮经会阴间质永久性前列腺近距离放射治疗，植入游离碘粒子94粒（1251粒）。植入的最小剂量设计为144戈瑞。结果：移植后第30天盆腔x线片显示缺5颗种子。在2005年10月10日因急性心肌梗塞入院前未做胸部x线摄影。心导管造影显示86颗金属微粒残留在骨盆区，4颗迁移到肺部（2颗左、2颗右），2颗迁移到心脏。两颗种子下落不明。在这两颗心脏种子中，一颗位于右心室心内膜，另一颗位于RCA中段严重狭窄病变部位，导致AMI。结论：据我们所知，这是首例近距离治疗种子迁移到RCA并伴有AML超声心动图的病例，在近距离治疗种子植入可能被认为是心脏分流高风险的患者之前。(C) 2006美国近距离放射治疗学会。版权所有。
PURPOSE: We report a case of prostate brachytherapy seed migration to the fight coronary artery (RCA) associated with an acute myocardial infarction (AMI).METHODS AND MATERIALS: A 69-year-old male was diagnosed with Prostate Adenocarcinoma Stage II (T1cN0M0) in October 2003. He underwent percutaneous transperineal interstitial permanent prostate brachytherapy with the implantation of 94 loose iodine (1251) seeds under transrectal ultrasound guidance on 15 December, 2003. The implantation was designed to deliver a minimum dose of 144 Gy.RESULTS: Postimplant pelvic radiography at Day 30 showed five seeds missing. No chest radiography was done until hospital admission on October 10, 2005 for AMI. Cine radiography from cardiac catheterization revealed 86 metallic seeds remaining in the pelvic region, 4 that had migrated to the lungs (2 left and 2 right) and 2 to the heart. Two seeds were unaccounted for. Of the two cardiac seeds, one was lodged in the right ventricle endocardium and the other in the mid-segment of the RCA at the site of a severely stenotic lesion that resulted in an AMI.CONCLUSIONS: To our knowledge, this is the first case of brachytherapy seed migration to the RCA associated with an AML Echocardiography before brachytherapy seed implantation might be considered in patients felt to be at high risk for cardiac shunting. (C) 2006 American Brachytherapy Society. All rights reserved.