Coronary Aneurysm After Endovascular Brachytherapy: True or False?

To the Editor: We read with great interest the article about the mechanism of action of endovascular brachytherapy after balloon angioplasty published by Sabate et al.1 Intravascular ultrasound (IVUS) imaging provides an extremely effective means of examining vessel changes after interventions and it seems to be critical in the objective evaluation of radiation therapy for restenosis.2 Angiographic follow-up of patients in several trials revealed a few cases of coronary or peripheral aneurysms.3 Ensuing speculations have questioned whether these malformations were true or false aneurysms. These entities have different prognoses. IVUS might help differentiate between true and false aneurysm.4 We previously reported that endovascular radiation might prevent or delay the early resolution of coronary dissection.5 It would be of great interest to know whether the aneurysm development was linked to an early dissection and if it was a true or false aneurysm on the basis of IVUS findings. …