Beta endovascular brachytherapy using CO2-filled centering catheter for treatment of recurrent superficial femoropopliteal artery disease.
BACKGROUND
Recurrent disease (restenosis) after endovascular treatment of the superficial femoral artery (SFA) remains a major problem. We evaluated the efficacy of beta-endovascular brachytherapy using the CORONA centering catheter in patients with SFA restenosis in a single-arm Phase II trial.


RESULTS
A total of 28 patients (mean age 70 years; 16 female, 12 male) with recurrent SFA stenosis were treated, and in-stent restenosis was present in 17 patients (61%). Brachytherapy was performed with strontium-90 beta source using a 7-French CO(2)-filled one-segment centering catheter. New stents had to be applied in two cases. Mean interventional length was 129 mm (range 20-240 mm). A dose of 14 Gy in vessel radius (postinterventional) plus 2 mm was applied in 24 patients and 18.4 Gy in four patients. Treatment time was 7 min 32 s per radiation segment. No major adverse events occurred. Patients were followed by ankle-brachial index and duplex sonography for a median of 42 months. Cumulative restenosis rates at 1, 2, and 3 years were 9%, 28%, and 40%, respectively. Target vessel revascularization was performed in seven cases (25%).


CONCLUSIONS
In comparison to literature data, the treatment of SFA restenosis with beta brachytherapy may improve long-term patency.
Pokrajac
Boris
B
Department of Radiotherapy, Medical University of Vienna, Vienna General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria. boris.pokrajac@meduniwien.ac.at
Kirisits
Christian
C
Schmid
Rainer
R
Schillinger
Martin
M
Berger
Daniel
D
Peer
Katarina
K
Tripuraneni
Prabhakar
P
Pötter
Richard
R
Minar
Erich
E
D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation; D001918:Brachytherapy / Q000295:instrumentation*; D002245:Carbon Dioxide; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D003251:Constriction, Pathologic; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000532:radiotherapy / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011150:Popliteal Artery / Q000503:physiopathology; D011446:Prospective Studies; D011829:Radiation Dosage; D012008:Recurrence; D015607:Stents; D013326:Strontium Radioisotopes / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
D010975:Platelet Aggregation Inhibitors; D013326:Strontium Radioisotopes; D002245:Carbon Dioxide