Vol 4, No 4 (2002)
Published online: 2003-02-10
Vascular brachytherapy after percutaneous transluminal angioplasty of iliac arteries - results of 18 months’ observation
Chirurgia Polska 2002;4(4):159-165.
Abstract
Background: In this article we present the results of treatment with vascular brachytherapy in iliac arteries. Vascular brachytherapy was applied to minimise the restenosis rate after percutaneous transluminal angioplasty.
Material and methods: Such treatment was performed in 15 cases. For treatment, patients were qualified with critical stenosis of the iliac artery confirmed in angiography. Among the 14 patients were 3 women. The mean age of the patients was 59.3 ± 10.6 years. In 8 cases the iliac common artery was narrowed, in the remaining cases the iliac external arteries were narrowed. Vascular brachytherapies were performed immediately after percutaneous angioplasties. The irradiation dose of 15 Gy was applied as one dose with high dose rate (HDR). This dose was calculated at a 3 mm distance from the internal surface of the artery wall. Mean time of observation was 18 months.
Results: In one patient, during the 4th month of observation, transit extremity ischaemia was observed due to temporary suspension of antiplatelet treatment. After reintroducing anticoagulant treatment these symptoms disappeared. In one patient 50% restenosis was revealed, in the remaining patients restenoses were not observed. This study was approved by the local Ethics Committee.
Conclusions: 1. The clinical pilot trial proved that with such safety conditions like precise irradiation of the treated section of an artery and antiplatelet treatment after intervention, vascular brachytherapy in iliac arteries seems to be a safe and feasible method. 2. The antiplatelet treatment should be ordered for at least 6 months following a stent implantation with subsequent vascular brachytherapy.
Material and methods: Such treatment was performed in 15 cases. For treatment, patients were qualified with critical stenosis of the iliac artery confirmed in angiography. Among the 14 patients were 3 women. The mean age of the patients was 59.3 ± 10.6 years. In 8 cases the iliac common artery was narrowed, in the remaining cases the iliac external arteries were narrowed. Vascular brachytherapies were performed immediately after percutaneous angioplasties. The irradiation dose of 15 Gy was applied as one dose with high dose rate (HDR). This dose was calculated at a 3 mm distance from the internal surface of the artery wall. Mean time of observation was 18 months.
Results: In one patient, during the 4th month of observation, transit extremity ischaemia was observed due to temporary suspension of antiplatelet treatment. After reintroducing anticoagulant treatment these symptoms disappeared. In one patient 50% restenosis was revealed, in the remaining patients restenoses were not observed. This study was approved by the local Ethics Committee.
Conclusions: 1. The clinical pilot trial proved that with such safety conditions like precise irradiation of the treated section of an artery and antiplatelet treatment after intervention, vascular brachytherapy in iliac arteries seems to be a safe and feasible method. 2. The antiplatelet treatment should be ordered for at least 6 months following a stent implantation with subsequent vascular brachytherapy.
Keywords: restenosisvascular brachytherapyiliac artery
