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Published online before print June 21, 2002, 10.1148/radiol.2242010882
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Endovascular Gamma Irradiation of Femoropopliteal de Novo Stenoses Immediately after PTA: Interim Results of Prospective Randomized Controlled Trial1

Karsten Krueger, MD, Peter Landwehr, MD, Mark Bendel, MD, Monika Nolte, PhD, Hartmut Stuetzer, MD, Rudolf Bongartz, MD, Markus Zaehringer, MD, Guido Winnekendonk, MD, Axel Gossmann, MD, Rolf-Peter Mueller, MD and Klaus Lackner, MD

1 From the Departments of Radiology (K.K., P.L., M.Z., G.W., A.G., K.L.), Radiooncology (M.B., M.N., R.B., R.P.M.), and the Institute for Medical Statistics, Informatics and Epidemiology (H.S.), University of Cologne, Joseph-Stelzmann-Strasse, D-50924 Cologne, Germany. From the 2001 RSNA scientific assembly. Received May 4, 2001; revision requested June 28; revision received October 9; accepted December 10. Supported by grant 1/98 from Cologne Fortune, a research program of the University of Cologne. Address correspondence to K.K. (e-mail: karsten.krueger@uni-koeln.de).



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  		Figure 1. Posteroanterior angiograms. Left: Digital subtraction angiogram in a patient with a short high-grade de novo stenosis (arrow) of the superficial femoral artery. Middle: Unsubtracted angiogram shows a catheter with a 10-cm-long segmented balloon used to center the 192Ir source in the artery. The centering catheter overlapped the length of stenosis by at least 1 cm at both sides. Patients received anticoagulant therapy during inflation of the balloon of the centering catheter to avoid blood clotting. Right: Digital subtraction angiogram shows the result of PTA performed in the same patient.

 


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  		Figure 2. Posteroanterior digital subtraction angiograms in a patient with peripheral occlusive disease stage 2b, according to Fontaine classification. Left: Intraarterial angiogram obtained before PTA shows a circumscribed high-grade de novo stenosis of the superficial femoral artery (arrow). Middle: Angiogram obtained after successful PTA, shows slight vessel-wall irregularities. The proximal and distal edges (arrows) of endovascular radiation are marked. Right: Angiogram obtained after 6 months demonstrates a normal vessel within the region of PTA and at the edges of the irradiated segment.

 


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  		Figure 3. Posteroanterior intraarterial digital subtraction angiograms in a patient with peripheral occlusive disease stage 2b, according to the Fontaine classification. Left: Angiogram obtained before PTA shows a short high-grade stenosis of the popliteal artery (arrow). Middle: Image shows the result of a successful PTA without endovascular irradiation. Right: Angiogram obtained after 6 months shows more than 50% restenosis (arrow).

 




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