title: Endovascular brachytherapy: effect on acute inflammatory response after percutaneous femoropopliteal arterial interventions.
abstract: OBJECTIVE
  To investigate whether endovascular brachytherapy diminishes vascular inflammation in response to femoropopliteal percutaneous transluminal angioplasty (PTA) or stent implantation in two double-blind randomized-controlled trials.
  
  
  METHODS
  Forty-seven consecutive patients from two double-blind randomized-controlled trials were studied. Patients either underwent femoropopliteal PTA with endovascular gamma irradiation (n = 8) or placebo irradiation (n = 7) or underwent PTA and stent implantation with brachytherapy (n = 15) or placebo irradiation (n = 17). High-sensitivity C-reactive protein (CRP), serum amyloid A (SAA), and fibrinogen levels were measured at baseline and 8, 24, and 48 hours after the intervention. The change of acute phase parameters from baseline to 48 hours after intervention indicated the extent of the inflammatory response and was compared between patients undergoing brachytherapy and those undergoing placebo irradiation. Fisher exact test was used for comparison of categorical data, and nonparametric statistical methods were applied for analysis of continuous data (Mann-Whitney U tests for unpaired data and Friedman analysis for repetitive measurements).
  
  
  RESULTS
  Median patient age was 70 years (interquartile range, 56-74 years); 33 (70%) patients were men and 14 (30%) were women. Clinical characteristics and baseline values of acute phase parameters were similar between groups. A statistically significant increase in CRP, SAA, and fibrinogen values was observed after PTA and stent implantation, both in the patients who underwent brachytherapy and in those who underwent placebo irradiation. Compared with placebo irradiation, however, brachytherapy did not significantly reduce any acute phase parameter from baseline to 8, 24, or 48 hours after the intervention (P >.05 for all comparisons).
  
  
  CONCLUSIONS
  Endovascular brachytherapy did not diminish early vascular inflammation in response to PTA or stent implantation and even induced a trend toward an increased inflammatory response.
authors.affiliation: Department of Angiology, University of Vienna, Medical School, Waehringer Guertel 18-20, A-1090 Vienna, Austria. martin.schillinger@akh-wien.ac.at
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mlekusch
authors.forename: Roswitha M
authors.initials: RM
authors.lastname: Wolfram
authors.forename: Alexandra C
authors.initials: AC
authors.lastname: Budinsky
authors.forename: Markus
authors.initials: M
authors.lastname: Exner
authors.forename: Helmut
authors.initials: H
authors.lastname: Rumpold
authors.forename: Oswald
authors.initials: O
authors.lastname: Wagner
authors.forename: Boris
authors.initials: B
authors.lastname: Pokrajac
authors.forename: Richard
authors.initials: R
authors.lastname: Pötter
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
mesh_terms: D000210:Acute-Phase Reaction / Q000175:diagnosis* / Q000276:immunology; D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000276:immunology / Q000532:radiotherapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007511:Ischemia / Q000276:immunology / Q000532:radiotherapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D018836:Inflammation Mediators