Endovascular brachytherapy for prevention of recurrent renal in-stent restenosis.
OBJECTIVE
To examine the ability of endovascular brachytherapy to prevent recurrent in-stent restenosis in patients at high risk for this complication.


METHODS
Thirteen renal stent patients (8 women; mean age 66 +/- 8 years) with an initial (n=9) or recurrent (n=4) in-stent restenosis underwent redilation followed by high-dose-rate brachytherapy (12 Gy of gamma radiation delivered to the target site 5 mm from an iridium-192 source axis).


RESULTS
The procedure was technically successful in 11 (85%) patients; in the other 2, the renal artery could not be accessed with the large sheaths required for brachytherapy. One patient with no clinical suspicion of restenosis died of an unrelated cause during the 1-year follow-up. Eight (80%) of 10 patients alive at 1 year had no in-stent restenosis apparent on duplex sonography or angiography. One of the postradiation recurrent restenoses was redilated, but the other patient was treated conservatively. CONCLUSIONS; Renal angioplasty followed by brachytherapy seems to be a feasible and efficient method to prevent recurrent in-stent restenosis in renal arteries at increased risk.
Stoeteknuel-Friedli
Sandra
S
Division of Angiology, University Hospital Bern, CH-3010 Bern, Switzerland.
Do
Dai-Do
DD
von Briel
Christian
C
Triller
Jürgen
J
Mahler
Felix
F
Baumgartner
Iris
I
D000368:Aged; D000800:Angioplasty, Balloon; D001918:Brachytherapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008297:Male; D011879:Radiotherapy Dosage; D012008:Recurrence; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000628:therapy*; D015607:Stents
D007496:Iridium Radioisotopes