Centered endovascular irradiation to prevent postangioplasty restenosis of arteriovenous fistula in hemodialysis patients; Results of a feasibility study.
OBJECTIVE
To report follow-up results of a prospective trial on centered endovascular gamma-irradiation (CEGI) after percutaneous transluminal angioplasty (PTA) for stenosis of arteriovenous fistula in hemodialysis patients.


METHODS
Eight patients receiving PTA for recurrent (n = 4) or de novo arteriovenous fistula stenoses were treated with CEGI with iridium-192 (14 Gy). Angiography was performed after 6 and 12 months or if problems reoccurred during hemodialysis. Parameters of hemodialysis and duplex sonography were determined the day before and after PTA and after 1, 3, 6, 9, and 12 months.


RESULTS
CEGI was performed successfully and without complications in seven patients. In six patients, restenosis occurred 6-52 weeks (mean 20.8 +/- 17.9 weeks) after PTA and required PTA. Parameters of hemodialysis and duplex sonography deteriorated during follow-up.


CONCLUSIONS
Centered endovascular gamma-irradiation with iridium 192 immediately after PTA of fistula stenoses was a safe and feasible method but did not prevent restenosis.
Department of Radiology, University of Cologne, Joseph-Stelzmann-Street, D-50924 Cologne, Germany. Krsten.Krueger@uni-koeln.de
Karsten
K
Krueger
Mark
M
Bendel
Markus
M
Zaehringer
Guido
G
Reinicke
Klaus
K
Lackner
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D004307:Dose-Response Relationship, Radiation; D005240:Feasibility Studies; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D010865:Pilot Projects; D011336:Probability; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome; D014654:Vascular Patency
D007496:Iridium Radioisotopes