Centered endovascular irradiation to prevent postangioplasty restenosis of arteriovenous fistula in hemodialysis patients; Results of a feasibility study

Cardiovasc Radiat Med. 2004 Jan-Mar;5(1):1-8. doi: 10.1016/j.carrad.2004.02.005.

Abstract

Purpose: To report follow-up results of a prospective trial on centered endovascular gamma-irradiation (CEGI) after percutaneous transluminal angioplasty (PTA) for stenosis of arteriovenous fistula in hemodialysis patients.

Methods and materials: Eight patients receiving PTA for recurrent (n = 4) or de novo arteriovenous fistula stenoses were treated with CEGI with iridium-192 (14 Gy). Angiography was performed after 6 and 12 months or if problems reoccurred during hemodialysis. Parameters of hemodialysis and duplex sonography were determined the day before and after PTA and after 1, 3, 6, 9, and 12 months.

Results: CEGI was performed successfully and without complications in seven patients. In six patients, restenosis occurred 6-52 weeks (mean 20.8 +/- 17.9 weeks) after PTA and required PTA. Parameters of hemodialysis and duplex sonography deteriorated during follow-up.

Conclusions: Centered endovascular gamma-irradiation with iridium 192 immediately after PTA of fistula stenoses was a safe and feasible method but did not prevent restenosis.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction
  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / methods
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Dose-Response Relationship, Radiation
  • Feasibility Studies
  • Female
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / radiotherapy*
  • Humans
  • Iridium Radioisotopes / therapeutic use*
  • Kidney Failure, Chronic / diagnostic imaging
  • Kidney Failure, Chronic / therapy*
  • Male
  • Pilot Projects
  • Probability
  • Prospective Studies
  • Renal Dialysis / adverse effects*
  • Renal Dialysis / methods
  • Risk Assessment
  • Treatment Outcome
  • Vascular Patency

Substances

  • Iridium Radioisotopes