External beam irradiation for inhibition of intimal hyperplasia following prosthetic bypass: preliminary results.
To determine whether external beam irradiation delivered immediately after graft implantation can inhibit anastomotic intimal hyperplasia (IH) 1 month following polytetrafluoroethylene (PTFE) bypass in a sheep carotid artery model, 23 sheep underwent bilateral bypass of the ligated common carotid artery with 8-mm PTFE immediately followed by a single dose of irradiation (15, 21, or 30 Gy) to one side. The 15 animals with bilaterally patent grafts were euthanized at 1 month and graft-arterial anastomoses harvested. Using computer-aided image analysis, IH areas and thicknesses were measured. Graft patency in this model was 83% at 1 month and did not differ according to treatment administered. In the control animals, IH was greatest at mid-anastomosis, but minimal within the native vessel. All three radiation doses markedly inhibited mid-anastomotic IH area and thickness. At the proximal anastomosis, 30 Gy reduced the IH area 20-fold, from 2.06 to 0.14 mm2 (p < 0.0001 by ANOVA), and IH thickness 70-fold, from 29.0 to 0.4 micron (p < 0.0002); similar effects were seen at the distal anastomosis. No adverse effects of radiation treatment were observed. External beam irradiation in doses of 15 to 30 Gy delivered in a single fraction immediately after operation markedly inhibits development of intimal hyperplasia 1 month following end-to-side anastomosis with PTFE in sheep.
Illig
K A
KA
Division of Vascular Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 652, Rochester, NY 14642, USA. Karl_Illig@URMC.Rochester.edu
Williams
J P
JP
Lyden
S P
SP
Hernady
E
E
Soni
A
A
Davies
M G
MG
Schell
M
M
Okunieff
P
P
Rubin
P
P
Green
R M
RM
D000818:Animals; D019917:Blood Vessel Prosthesis Implantation; D002339:Carotid Arteries / Q000528:radiation effects / Q000601:surgery; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D005260:Female; D006965:Hyperplasia / Q000188:drug therapy / Q000517:prevention & control / Q000532:radiotherapy; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D012756:Sheep; D016896:Treatment Outcome; D017539:Tunica Intima / Q000473:pathology* / Q000528:radiation effects*; D014654:Vascular Patency / Q000528:radiation effects
D011138:Polytetrafluoroethylene