External beam radiation to prevent restenosis after superficial femoral artery balloon angioplasty.

Abstract:

BACKGROUND:Femoropopliteal percutaneous transluminal angioplasty (PTA) remains limited by restenosis. Although vascular brachytherapy may be effective in reducing restenosis, external beam radiation would be more practical to administer after PTA. METHODS AND RESULTS:After femoropopliteal PTA without stent placement, 99 patients were randomly assigned to 0 Gy (placebo; n=24), 7 Gy (n=24), 10.5 Gy (n=26), or 14 Gy (n=25) of external beam radiation of the PTA site (with a 3-cm margin at both extremities) in 1 session 24 hours after PTA. The primary end point was minimum lumen diameter on quantitative angiography 1 year after PTA. One year after PTA, the mean minimum lumen diameter was 1.92, 1.64, 1.92, and 2.91 mm, respectively, for the 0-, 7-, 10.5-, and 14-Gy groups (P=0.0072 for 0 versus 14 Gy). Mean luminal loss was 1.14, 1.27, 1.08, and 0.14 mm, respectively, for the 4 groups (P=0.0072 for 0 versus 14 Gy). Restenosis >50% was present in 50%, 65%, 48%, and 25% of patients, respectively, for the 0-, 7-, 10.5-, and 14-Gy groups (P=0.072). At 18 months, repeated revascularizations were required in 25% of patients in the 0-Gy group versus 12% of patients in the 14-Gy group (P=0.24). CONCLUSIONS:A single session of external beam radiation of 14 Gy of the femoropopliteal angioplasty site significantly reduces restenosis at 1 year.

journal_name

Circulation

journal_title

Circulation

authors

Therasse E,Donath D,Lespérance J,Tardif JC,Guertin MC,Oliva VL,Soulez G

doi

10.1161/CIRCULATIONAHA.104.502179

subject

Has Abstract

pub_date

2005-06-21 00:00:00

pages

3310-5

issue

24

eissn

0009-7322

issn

1524-4539

pii

CIRCULATIONAHA.104.502179

journal_volume

111

pub_type

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