Endovascular Brachytherapy for Prophylaxis of Restenosis After Femoropopliteal Angioplasty

Minar, Erich; Pokrajac, Boris; Maca, Thomas; Ahmadi, Ramazanali; Fellner, Claudia; Mittlböck, Martina; Seitz, W.; Wolfram, Roswitha; Pötter, Richard

doi:10.1161/01.cir.102.22.2694

Cited by 181 publications

(127 citation statements)

References 19 publications

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“…Methods to limit MIH include the use of external and local intraluminal ionizing radiation 7 and the use of drug-eluting stents. 8 The latter approach avoids certain safety and technical problems with radiation or isotope therapy.…”

Section: Introductionmentioning

confidence: 99%

Dose-dependent Inhibition of Myointimal Hyperplasia by Orally Administered Rapamycin

Uchimura

Perera

Fujitani

et al. 2004

Annals of Vascular Surgery

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Myointimal hyperplasia (MIH) after vascular intervention is a major problem. Recent reports describing elimination of within-stent restenosis by means of rapamycin-eluting stents prompted us to examine the effect of systemic oral rapamycin on MIH induced by arterial trauma. We studied the effect of oral rapamycin on MIH after rabbit aorta balloon injury. Thirty-five New Zealand white rabbits (2.5-3 kg) had aortic injury and were given either no rapamycin (control), 0.1 (low dose) rapamycin mg/kg/day, or 0.4 mg/kg/day (high dose). Rapamycin was started 1 week before injury and continued for 3 (4 weeks total) or 6 weeks (7 weeks total) post-injury. Sections were analyzed to measure aortic intima/media area ratios (I:M) at either 3 or 6 weeks. At 3 weeks, the I:M (mean ± SD) for controls was 0.53 ± 0.1; for low dose, 0.17 ± 0.13; and for high dose, 0.24 ± 0.07 (p < 0.001 vs. control). At 6 weeks, the I:M for controls was 0.52 ± 0.12; for low dose-4 weeks, 0.29 ± 0.15; low dose-7 weeks, 0.33 ± 0.07; and high dose-4 weeks, 0.47 ± 0.16. At 6 weeks only the difference between the low dose-4 weeks and control I:M ratios was significant (p = 0.018). The results confirm earlier studies showing that systemic rapamycin inhibits MIH after arterial injury when drug therapy is started before injury. Therapy for 3 or 6 weeks after injury yields similar inhibition, indicating that exposure to the drug early in the response to injury is more important than prolonged exposure. We observed a paradoxical relation between dose and degree of MIH inhibition, with the low dose being more effective than the high dose at both time intervals studied. Overall, the results suggest that oral rapamycin therapy might be a useful adjunct to clinical interventions at risk for development of MIH.

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Section: Introductionmentioning

confidence: 99%

Dose-dependent Inhibition of Myointimal Hyperplasia by Orally Administered Rapamycin

Uchimura

Perera

Fujitani

et al. 2004

Annals of Vascular Surgery

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show abstract

“…Following reports from several small registries, 22,23 a randomized study of 113 patients compared ␥-radiation to placebo after balloon angioplasty of long segment and/or occluded superficial femoral artery disease. 30 Treatment with radiation increased cumulative patency at 12 months from 35.3% in placebo to 63.6% in treated patients (PϽ0.005). Thus, radiation appears to be an effective antirestenosis strategy for patients undergoing peripheral as well as coronary intervention.…”

Section: Teirstein and Kuntz Intravascular Radiation To Prevent Restementioning

confidence: 99%

New Frontiers in Interventional Cardiology

Teirstein

Kuntz

2001

Circulation

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“…Use of paclitaxel-coated angioplasty balloons during percutaneous treatment of www.intechopen.com femoropopliteal disease has been shown to be associated with significant reductions in late lumen loss (Tepe et al, 2008). Endovascular brachytherapy has been proposed as a promising treatment modality to reduce restenosis after angioplasty (Minar et al, 2000). However, the phenomenon of late acute thrombotic occlusion in patients receiving endovascular brachytherapy after stenting of the femoropopliteal arteries may compromise the benefits of endovascular radiation.…”

Section: Wwwintechopencommentioning

confidence: 99%

Antithrombotic Therapy After Peripheral Angioplasty

Zalunardo¹,

Tonello²,

Busato³

et al. 2012

Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses

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Endovascular Brachytherapy for Prophylaxis of Restenosis After Femoropopliteal Angioplasty

Abstract: This is the first randomized study to demonstrate the efficacy of endovascular BT for prophylaxis of restenosis after femoropopliteal PTA. The value of this approach should now be improved by modification of the BT procedure and by combination with stent implantation.

Cited by 181 publications

References 19 publications

Dose-dependent Inhibition of Myointimal Hyperplasia by Orally Administered Rapamycin

Dose-dependent Inhibition of Myointimal Hyperplasia by Orally Administered Rapamycin

New Frontiers in Interventional Cardiology

Antithrombotic Therapy After Peripheral Angioplasty

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