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Endovascular brachytherapy using liquid Beta-emitting rhenium-188 for the treatment of long-segment femoropopliteal in-stent stenosis.
- Source :
-
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2012 Aug; Vol. 19 (4), pp. 467-75. - Publication Year :
- 2012
-
Abstract
- Purpose: To evaluate the efficacy and safety of endovascular brachytherapy with liquid beta-emitting rhenium-188 (Re-188) in patients with long-segment in-stent stenosis in the femoropopliteal segment.<br />Methods: From July 2009 to April 2011, 90 consecutive patients (59 men; mean age 68.3±10.3 years, range 43-86) with symptomatic in-stent stenosis/occlusion (24.6-cm mean lesion length) of the femoropopliteal segment underwent angioplasty and subsequent endovascular brachytherapy. The liquid beta-emitting Re-188 was applied to the target lesion within an angioplasty balloon using a dose of 13 Gy at a depth of 2 mm into the vessel wall. Clinical and angiographic follow-up data were collected up to 2 years. The main study endpoints were the 6- and 12-month primary patency rates defined as <50% in-stent stenosis as detected by duplex ultrasound. Clinical endpoints were the cumulative rates of death, amputation, and bypass surgery, as well as improvement in the Rutherford category and the ankle-brachial index. Results were correlated with patient and lesion characteristics.<br />Results: Primary technical success was achieved in all patients, with 1 early stent thrombosis, but no other complications related to the irradiation. Eighty-eight patients reached the 6-month and 82 the 12-month examinations; the primary patency was 95.2% and 79.8%, respectively. In-stent stenosis occurred in 9 patients, while 10 patients had reocclusion of the treated segment. During follow-up, there were 2 late acute thrombotic occlusions, both after discontinuation of clopidogrel. The clinical status improved in 67.0% and 62.2% of the patients after 6 and 12 months, respectively. No patient, lesion, or procedure variables were predictive of restenosis after EVBT.<br />Conclusion: EVBT with liquid beta-emitting Re-188 was safe and effective in preventing restenosis in long-segment femoropopliteal ISS.
- Subjects :
- Adult
Aged
Aged, 80 and over
Amputation, Surgical
Angioplasty, Balloon adverse effects
Arterial Occlusive Diseases diagnosis
Arterial Occlusive Diseases physiopathology
Arterial Occlusive Diseases radiotherapy
Brachytherapy adverse effects
Chi-Square Distribution
Constriction, Pathologic
Disease-Free Survival
Female
Germany
Humans
Kaplan-Meier Estimate
Limb Salvage
Male
Middle Aged
Predictive Value of Tests
Radiography
Radioisotopes adverse effects
Recurrence
Retrospective Studies
Rhenium adverse effects
Risk Assessment
Risk Factors
Thrombosis etiology
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Duplex
Vascular Patency
Angioplasty, Balloon instrumentation
Arterial Occlusive Diseases therapy
Brachytherapy methods
Femoral Artery diagnostic imaging
Femoral Artery physiopathology
Popliteal Artery diagnostic imaging
Popliteal Artery physiopathology
Radioisotopes therapeutic use
Rhenium therapeutic use
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1545-1550
- Volume :
- 19
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
- Publication Type :
- Academic Journal
- Accession number :
- 22891824
- Full Text :
- https://doi.org/10.1583/12-3832R.1