Document Detail


External beam irradiation and restenosis following femoral stenting: long-term results of a prospective randomized study.
MedLine Citation:
PMID:  17295082     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess the long-term outcome of external beam irradiation (EBI) for the prevention of restenosis due to neointimal hyperplasia, following percutaneous transluminal angioplasty (PTA) and stenting of the superficial femoral artery. METHODS: Sixty consecutive patients with peripheral arterial disease, who were treated with "bail-out" stent implantation in the superficial femoral artery due to suboptimal PTA, were included in this study. Patients were randomly allocated into two groups, receiving either external beam irradiation (6 MV photons, total dose 24 Gy in a hypofractionated schedule) plus antiplatelet therapy (EBI group) or antiplatelet therapy alone (control group). RESULTS: No procedure-related complications occurred, and all patients of the EBI group received the full dose of 24 Gy. During the long-term follow-up, an overall statistically significant difference was demonstrated in favor of the EBI group patients, regarding both the in-stent (log-rank test, p = 0.0072) and the in-segment binary restenosis (log-rank test, p = 0.0103). The primary patency rates were also significantly better in the EBI group at specific time-points, such as in the first (74.2% vs 46.5%, p = 0.019), second (62.5% vs 33.8%, p = 0.020), and third (54.6% vs 29.0%, p = 0.039) year, respectively. Moreover, the overall clinically driven reintervention rate was significantly lower among patients of the irradiated group (log-rank test, p = 0.038). CONCLUSION: Our long-term follow-up analysis revealed that EBI following femoral artery PTA and stenting significantly reduces restenosis and reintervention rates, while improving primary patency.
Authors:
Petros Zampakis; Dimitrios Karnabatidis; Christina Kalogeropoulou; Dimitrios M Kardamakis; Konstantinos Katsanos; Theodoros Skouras; Dimitrios Siablis
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  30     ISSN:  0174-1551     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    2007 May-Jun
Date Detail:
Created Date:  2007-04-13     Completed Date:  2007-10-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  362-9     Citation Subset:  IM    
Affiliation:
Department of Radiology, University Hospital of Patras Medical School, 265 00 Patras, Greece.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon*
Arterial Occlusive Diseases / therapy*
Aspirin / therapeutic use
Combined Modality Therapy
Dose Fractionation
Female
Femoral Artery / radiation effects*
Fibromuscular Dysplasia / radiotherapy*
Follow-Up Studies
Humans
Male
Middle Aged
Particle Accelerators
Platelet Aggregation Inhibitors / therapeutic use
Prospective Studies
Recurrence / prevention & control
Retreatment
Stents*
Ticlopidine / analogs & derivatives,  therapeutic use
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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