| Brachytherapy with iridium-192 HDR to prevent from restenosis in peripheral arteries. An update. | |
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MedLine Citation:
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PMID: 9816526 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The use of stents does not appreciably improve restenosis (usually resulting from intimal hyperplasia) as compared to percutaneous transluminal angioplasty (PTA) alone. The development of small-caliber probes for afterloading therapy in the biliary tract allowed us to use these for therapy in the vascular system. Using a special 9 F catheter, exact measurement of the length of the stented vascular segment and of the insertion length of the afterloading probe could be reproducibly performed. We used a Nucletron (Micro) Selectron HDR planning system version 10.10 for exact calculation, monitoring, and control of the afterloading procedure. Our source was iridium 192 (10 Ci) with a diameter of 1.1 mm. The program controls and monitors the insertion and removal of the iridium probe from the source into the special catheter through to the tip, and monitors the irradiation duration. The exposure time was around 200 seconds for a surface dose of 12 Gy. To date, a total of 40 patients have been treated with endovascular afterloading. All patients suffered from clinically relevant reocclusions or restenoses in stented vascular segments of the superficial femoral artery following successful PTA or laser treatment, within 6 to 8 months after the last therapy. In all patients it was possible to perform re-PTA treatment without remaining residual stenoses in the stented region. The additional time required as compared to PTA alone was approximately 45 minutes with most of this time spending for transportation between the cath lab and afterloading room. The follow-up period of the 40 patients ranged from 4 months to 71/2 years. In 33 patients, there was no deterioration of the clinical stage and no restenosis. One patient suffered from an acute thrombosis approximately 3 months after stent implantation, another patient had a stenosis 3 cm above the stented vascular segment 12 months after irradiation treatment. Follow-up examinations have revealed no evidence of nerve lesions following irradiation therapy. The tissue surrounding the artery showed no change following irradiation therapy, either in the CT, color-coded Doppler, endovascular ultrasonic scan or MRI. No complaints of discomfort were reported during or after irradiation. With the exceptions mentioned above, there was no evidence of any complications. |
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Authors:
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D Liermann; J Kirchner; R Bauernsachs; B Schopohl; H D Böttcher |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Herz Volume: 23 ISSN: 0340-9937 ISO Abbreviation: Herz Publication Date: 1998 Sep |
Date Detail:
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Created Date: 1999-01-26 Completed Date: 1999-01-26 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7801231 Medline TA: Herz Country: GERMANY |
Other Details:
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Languages: eng Pagination: 394-400 Citation Subset: IM |
Affiliation:
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Clinic of Radiology and Nuclear Medicine, Hospital of the Ruhr University Bochum, Germany. Dieter.Liermann@ruhr-uni-bochum.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Angioplasty, Balloon / instrumentation* Arterial Occlusive Diseases / radiotherapy* Brachytherapy / instrumentation* Equipment Design Female Follow-Up Studies Humans Iridium Radioisotopes / therapeutic use* Male Middle Aged Recurrence Retreatment Stents* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Iridium Radioisotopes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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