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    Dunedin woman chooses alternative to angioplasty

    She is the first in the bay area to try brachytherapy: radiation to clear a heart vessel.

    By ERIC STIRGUS

    © St. Petersburg Times, published May 24, 2001


    CLEARWATER -- Tired of the constant chest pains and return trips to the hospital since her angioplasty in April 2000, Mary Schulz could have had the procedure done again but doctors offered an alternative never performed before in the Tampa Bay area.

    Schulz, 52, opted to have a small dose of radiation inserted into her heart vessel through a wire. The radiation would reopen the artery and thus eliminate her chest pains.

    The thought of having radiation directly put into her body did not bother Schulz, who spends her time between Dunedin and Indianapolis as a JCPenney sales clerk. An avid golfer, Schulz was ready to get back on the links.

    "No problem," Schulz told the doctors. "If it works, let's get on it."

    On Wednesday morning, Schulz arrived at Morton Plant Hospital for the procedure. By the afternoon, she was telling jokes from her hospital bed and eager to play golf again -- which her doctor promised she could do by Friday.

    "I've got good doctors, but I'm tired of seeing your faces," she said Wednesday afternoon.

    Many physicians are excited by this new procedure, known as brachytherapy, which they say will greatly reduce the chances of arteries reclogging. Between 10 percent and 20 percent of angioplasty patients need the procedure performed again, a frustrating problem.

    "It's a great way to solve a problem that had been recurring," said Patrick A. Cambier, the physician who performed the procedure on Schulz. "This is a major advance."

    Other doctors have been more cautious in their remarks. They say there has not been enough time to fully review the impact of brachytherapy -- in particular, whether the radiation may cause cancer. In one study, some patients suffered dangerous blood clots.

    "It sounds wonderful and it may turn out great," said Dr. Kevin A. Garner, assistant clinical professor at the University of South Florida and the director of the cardiac catheterization lab at Bayfront Medical Center. "I just think it will take time and patience to get enough of a feel."

    Brachytherapy was first practiced in South American in the early 1990s. The U.S. Food and Drug Administration approved the procedure last year. It differs from angioplasty in that the radiation prevents the build-up of tissue and muscle within arteries that creates clogging.

    The process of inserting the radiation into the vessel is as quick as changing a tire. The first step is to place a guide wire inside the vessel. A catheter is run inside the guide wire. That catheter is connected to a small, footlong metal device called a "pig," which holds the radiation.

    The catheter is inserted at the area of blockage. All told, the procedure takes 15 to 20 minutes, and physicians say the amount of radiation is no greater than what is used for a chest X-ray.

    Morton Plant Hospital uses a system made by Cordis, a Johnson & Johnson subsidiary, to perform the procedure. There are less than a handful of hospitals in Florida that perform the procedure.

    Although she was sedated, Schulz was alert throughout the procedure. Schulz looks forward to having no more chest pains.

    "I just hope it does what it is supposed to do," she said.

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