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Online ISSN 1827-1847
Boselli G. 1, Benincasa A. 1, Lò G. 1, Casali G. 1, Tusini N. 1, Vecchiati E. 1, Armaroli L. 2
1 Unit of Vascular Surgery
2 Unit of Radiotherapy Azienda Ospedaliera A.S.M.N., Reggio Emilia
Background. Restenosis remains a major problem after percutaneous transluminal angioplasty of coronary and peripheral arteries. Arterial response to PTA-stenting, because of myointimal cell proliferation and intimal hyperplasia, causes restenosis and re-obstruction of femoro-popliteal segments in 40% of cases. Ionizing radiation to control intimal proliferation is known and has been recently applied to endovascular surgery. We report our experience with endovascular 192Ir high dose rate brachytherapy.
Methods. From June 1999 to September 2001 we treated 24 single or multiple occlusions and 21 stenoses of femoro-popliteal vessels in 45 nonrandomized patients (20 in Fontaine stage 3 or 4, 21 in stage 2b). Immediately after the endovascular procedure, patients received endovascular 192Ir HDR brachytherapy (1400 cGy).
Results. Immediate results of arterial patency were 95%, with no morbidity or mortality; long-term patency was achieved in 80% versus 72% in an analogous series without brachytherapy.
Conclusions. Endovascular 192Ir HDR brachytherapy was found to be safe and feasible. Long-term results of arterial patency seem to be promising. More studies are needed to demonstrate treatment efficacy in the prevention of restenosis.
language: English, Italian