Cardiovascular revascularization medicine : including molecular interventions · 2009
Beta endovascular brachytherapy using CO2-filled centering catheter for treatment of recurrent superficial femoropopliteal artery disease.
Клиническое исследование II фазыСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Pokrajac Boris, Kirisits Christian, Schmid Rainer, Schillinger Martin, Berger Daniel, Peer Katarina, Tripuraneni Prabhakar, Pötter Richard, Minar Erich
Аннотация
BACKGROUND: Recurrent disease (restenosis) after endovascular treatment of the superficial femoral artery (SFA) remains a major problem. We evaluated the efficacy of beta-endovascular brachytherapy using the CORONA centering catheter in patients with SFA restenosis in a single-arm Phase II trial.
METHODS AND RESULTS: A total of 28 patients (mean age 70 years; 16 female, 12 male) with recurrent SFA stenosis were treated, and in-stent restenosis was present in 17 patients (61%). Brachytherapy was performed with strontium-90 beta source using a 7-French CO(2)-filled one-segment centering catheter. New stents had to be applied in two cases. Mean interventional length was 129 mm (range 20-240 mm). A dose of 14 Gy in vessel radius (postinterventional) plus 2 mm was applied in 24 patients and 18.4 Gy in four patients. Treatment time was 7 min 32 s per radiation segment. No major adverse events occurred. Patients were followed by ankle-brachial index and duplex sonography for a median of 42 months. Cumulative restenosis rates at 1, 2, and 3 years were 9%, 28%, and 40%, respectively. Target vessel revascularization was performed in seven cases (25%).
CONCLUSIONS: In comparison to literature data, the treatment of SFA restenosis with beta brachytherapy may improve long-term patency.
METHODS AND RESULTS: A total of 28 patients (mean age 70 years; 16 female, 12 male) with recurrent SFA stenosis were treated, and in-stent restenosis was present in 17 patients (61%). Brachytherapy was performed with strontium-90 beta source using a 7-French CO(2)-filled one-segment centering catheter. New stents had to be applied in two cases. Mean interventional length was 129 mm (range 20-240 mm). A dose of 14 Gy in vessel radius (postinterventional) plus 2 mm was applied in 24 patients and 18.4 Gy in four patients. Treatment time was 7 min 32 s per radiation segment. No major adverse events occurred. Patients were followed by ankle-brachial index and duplex sonography for a median of 42 months. Cumulative restenosis rates at 1, 2, and 3 years were 9%, 28%, and 40%, respectively. Target vessel revascularization was performed in seven cases (25%).
CONCLUSIONS: In comparison to literature data, the treatment of SFA restenosis with beta brachytherapy may improve long-term patency.
Предметные рубрики MeSH
AgedAngioplasty, BalloonBrachytherapyCarbon DioxideCatheterization, PeripheralConstriction, PathologicEquipment DesignFemaleFemoral ArteryHumansKaplan-Meier EstimateMalePeripheral Vascular DiseasesPlatelet Aggregation InhibitorsPopliteal ArteryProspective StudiesRadiation DosageRecurrenceStentsStrontium RadioisotopesTime FactorsTreatment OutcomeVascular Patency