Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

DOI: 10.1148/radiol.2203010038
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wolfram, R. M.
Right arrow Articles by Minar, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wolfram, R. M.
Right arrow Articles by Minar, E.
(Radiology. 2001;220:724-729.)
© RSNA, 2001

Radiation Oncology

Endovascular Brachytherapy for Prophylaxis against Restenosis after Long-Segment Femoropopliteal Placement of Stents: Initial Results1

Roswitha M. Wolfram, MD, Boris Pokrajac, MD, Ramazanali Ahmadi, MD, Claudia Fellner, PhD, Mariann Gyöngyösi, PhD, Markus Haumer, MD, Robert Bucek, MD, Richard Pötter, MD and Erich Minar, MD

1 From the Departments of Angiology (R.M.W., R.A., M.H., R.B., E.M.), Radiotherapy and Radiobiology (B.P., C.F., R.P.), and Cardiology (M.G.), University of Vienna General Hospital, Währinger Gürtel 18-20, A-1097 Vienna, Austria. Received November 28, 2000; revision requested January 11, 2001; revision received March 19; accepted April 9. Address correspondence to E.M. (e-mail: erich.minar@akh-wien.ac.at).

PURPOSE: To evaluate the feasibility, safety, and effectiveness of endovascular brachytherapy for the prevention of restenosis after long-segment femoropopliteal percutaneous transluminal angioplasty (PTA) and stent implantation.

MATERIALS AND METHODS: Thirty-three patients (23 men, 10 women; mean age, 66 years) with femoropopliteal lesions (mean treated length, 17 cm; range, 4–30 cm) underwent PTA and stent implantation followed by brachytherapy with a centering catheter. A dose of 14 Gy was delivered to the adventitia by using an iridium 192 source. Long-term pharmacotherapy with acetylsalicylic acid was combined with clopidogrel for 1 month. Follow-up examinations included measurement of the ankle-brachial index, color-coded duplex ultrasonography, and angiography.

RESULTS: The overall 6-month recurrence rate was 30% (10 of 33 arteries). Seven patients developed sudden late thrombotic occlusion of the segment with the stent 3.5–6 months after stent implantation. Considering the overall results after successful local thrombolysis in six of these seven patients, only four (12%) of 33 arteries with a stent had in-stent restenosis caused by neointimal hyperplasia.

CONCLUSION: The study results are promising concerning the possibility of reducing in-stent restenosis by means of brachytherapy after long-segment femoropopliteal placement of stents. The high incidence of late thrombotic occlusion requires optimization of the antithrombotic regimen.

Index terms: Arteries, stenosis or obstruction, 92.72 • Arteries, transluminal angioplasty, 92.1286 • Iridium, radioactive • Stents and prostheses, 92.1286 • Stents and prostheses, radiation, 92.1286




This article has been cited by other articles:


Home page
 Vasc MedHome page
T. Zeller
Current state of endovascular treatment of femoro-popliteal artery disease
Vascular Medicine, August 1, 2007; 12(3): 223 - 234.
[Abstract] [PDF]

Home page
 RadiologyHome page
R. M. Wolfram, A. C. Budinsky, B. Pokrajac, R. Potter, and E. Minar
Endovascular Brachytherapy for Prophylaxis of Restenosis after Femoropopliteal Angioplasty: Five-year Follow-up--Prospective Randomized Study
Radiology, September 1, 2006; 240(3): 878 - 884.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
R. M. Wolfram, A. C. Budinsky, B. Pokrajac, R. Potter, and E. Minar
Vascular Brachytherapy with 192Ir after Femoropopliteal Stent Implantation in High-Risk Patients: Twelve-month Follow-up Results from the Vienna-5 Trial
Radiology, July 1, 2005; 236(1): 343 - 351.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. A. Bettmann, M. D. Dake, L. N. Hopkins, B. T. Katzen, C. J. White, A. C. Eisenhauer, W. H. Pearce, K. A. Rosenfield, R. W. Smalling, T. A. Sos, et al.
Atherosclerotic Vascular Disease Conference: Writing Group VI: Revascularization
Circulation, June 1, 2004; 109(21): 2643 - 2650.
[Full Text] [PDF]

Home page
 RadiologyHome page
M. Schillinger, W. Mlekusch, R. M. Wolfram, A. C. Budinsky, M. Exner, H. Rumpold, O. Wagner, B. Pokrajac, R. Potter, and E. Minar
Endovascular Brachytherapy: Effect on Acute Inflammatory Response after Percutaneous Femoropopliteal Arterial Interventions
Radiology, February 1, 2004; 230(2): 556 - 560.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
R. Bonvini, I. Baumgartner, D. D. Do, M. Alerci, J.-M. Segatto, P. Tutta, K. Jager, M. Aschwanden, E. Schneider, B. Amann-Vesti, et al.
Late acute thrombotic occlusion after endovascular brachytherapy and stenting of femoropopliteal arteries
J. Am. Coll. Cardiol., February 5, 2003; 41(3): 409 - 412.
[Abstract] [Full Text] [PDF]

Home page
 PERSPECT VASC SURG ENDOVASC THERHome page
G. Mozes and P. Gloviczki
Adjuvant Therapy in Lower Extremity Revascularization: Prevention of Early and Intermediate Failures
Perspectives in Vascular Surgery and Endovascular Therapy, January 1, 2002; 15(2): 161 - 180.
[Abstract] [PDF]