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Vascular Brachytherapy with ¹⁹²Ir after Femoropopliteal Stent Implantation in High-Risk Patients: Twelve-month Follow-up Results from the Vienna-5 Trial¹

¹ From the Departments of Angiology (R.M.W., A.C.B., E.M.) and Radiotherapy and Radiobiology (B.P., R.P.), Medical University of Vienna, Waehringer Guertel 18, A-1090 Vienna, Austria. Received April 18, 2004; revision requested June 25; revision received July 30; accepted August 26. Address correspondence to R.M.W. (e-mail: roswitha.wolfram{at}hotmail.com).

View larger version (140K): [in a new window]   Figure 1. Angiograms obtained in a 79-year-old woman (a) with occlusion in distal superficial femoral and popliteal artery (between arrows). (b) Angiogram of femoropopliteal artery obtained immediately after PTA and stent implantation. Note the dilated segment (between arrows). (c) Follow-up angiogram obtained at 5-month follow-up demonstrates recurrence after long-segment PTA and stent implantation. Note the formerly dilated segment (between arrows).

View larger version (124K): [in a new window]   Figure 2. Angiograms obtained in a 74-year-old man (a) with long segment stenosis (between arrows) of the distal superficial femoral artery. (b) Angiogram of femoropopliteal artery obtained immediately after PTA and stent implantation. Note the segment that has been dilated and in which a stent has been placed (between arrows) and the segment that has been irradiated (between lines). (c) Angiogram obtained at 8-month follow-up demonstrates optimal results after stent implantation followed by brachytherapy. Note the segment in which a stent was previously placed (between arrows) and the segment that was previously irradiated (between lines).

View larger version (17K): [in a new window]   Figure 3. Graph shows Kaplan-Meier analysis for cumulative patency rate after femoropopliteal stent implantation, according to assigned treatment. Patients treated with only stent implantation are represented by the solid line, and patients treated with stent implantation and brachytherapy are represented by the broken line. One-year patency rate was 41% in patients treated with stent implantation versus 57% in patients treated with stent implantation and brachytherapy (log-rank test, P = .32). Numbers below the graph indicate the number of patients at risk.

View larger version (16K): [in a new window]   Figure 4. Graph shows Kaplan-Meier analysis for clinical patency after femoropopliteal stent implantation, according to assigned treatment. Patients treated with only stent implantation are represented by the solid line, and patients treated with stent implantation and brachytherapy are represented by the broken line. One-year clinical patency was 54% in patients treated with stent implantation and 62% in patients treated with stent implantation and brachytherapy (log-rank test, P = .50). Numbers below the graph indicate the number of patients at risk.