Document Detail

Experimental and clinical evaluation of the PARIS centering catheter for delivery of endovascular gamma-irradiation of femoropopliteal stenoses.
MedLine Citation:
PMID:  12160762     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To investigate the effect of aortic bifurcation and iliac geometry on centered endovascular irradiation (CEI) of femoropopliteal arteries and evaluate procedure-related complications. MATERIALS AND METHODS: In an experimental tubing model, crossover delivery of the dummy wire by an afterloader using different sheaths (Type I: noncrossover; Type II: crossover, length 40 cm; Type III: crossover, length 65 cm) was examined at simulated angles between 20 degrees -100 degrees (aortic bifurcation) and 0 degrees -100 degrees (iliac vessels). In the clinical phase, 28 heparin-anticoagulated patients underwent percutaneous transluminal angioplasty (PTA) for femoropopliteal stenoses followed by CEI (192-iridium, 14 Gray at 2 mm depth of the vessel wall) delivered with the centering catheter (crossover from contralateral leg using a 65-cm-long 8F sheath in 13 patients, noncrossover from ipsilateral leg using a 10-cm 8F sheath in 15 patients). Measurement of the aortic bifurcation angle before advancement of the crossover sheath and rating of iliac artery tortuosity on both sides was retrospectively performed on angiograms. Fifteen controls received no post-PTA CEI. RESULTS: Experimental delivery of the dummy wire was not possible at aortic angles less than 40 degrees with Type I, 60 degrees with Type II, and 30 degrees with Type III sheaths. Advancement of the centering catheter was possible in all patients. CEI failed in two patients with crossover (aortic angle <40 degrees ) and in one obese patient with antegrade approach because advancement of the dummy wire was impossible. Thromboembolism rate was 4.6% during irradiation (2.3% after PTA alone). CONCLUSIONS: CEI in femoropopliteal arteries has a risk of procedure-related thromboembolic complications. Efficacy is affected by vessel geometry.
K Krueger; M Bendel; M Zaehringer; C Weise; K Lackner
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiovascular radiation medicine     Volume:  2     ISSN:  1522-1865     ISO Abbreviation:  Cardiovasc. Radiat. Med.     Publication Date:    2001 Oct-Dec
Date Detail:
Created Date:  2002-08-05     Completed Date:  2002-10-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100888865     Medline TA:  Cardiovasc Radiat Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  213-20     Citation Subset:  IM    
Department of Radiology, Medical School, University of Cologne, Joseph-Stelzmann-Str., D-50924 Cologne, Germany.
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MeSH Terms
Angioplasty, Balloon
Brachytherapy / instrumentation*,  methods
Constriction, Pathologic / radiotherapy
Femoral Artery*
Popliteal Artery*
Vascular Diseases / radiotherapy*

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