Gamma radiation induces positive vascular remodeling after balloon angioplasty: A prospective, randomized intravascular ultrasound scan study

Hagenaars, Tjebbe; Po, I.F.Lim A; Sambeek, Marc R.H.M. van; Coen, V.; Tongeren, R.B.M. van; Gescher, F.; Wittens, Cees H. A.; Boelhouwer, Roelof U.; Pattynama, P.M.T.; Gussenhoven, Elma J.

doi:10.1067/mva.2002.124373

Cited by 18 publications

(6 citation statements)

References 32 publications

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“…Gamma radiation has induced positive vascular remodeling after balloon angioplasty in a prospective randomized intravascular ultrasound (IVUS) scan study. 23 When doses of 12-14 Gy (gamma radiation) are applied endoluminally to the femoropopliteal segment after PTA, there is a two-fold increase in 12-month patency compared to untreated controls. [24][25][26] Similar results were noted in the PARIS trial.…”

Section: Brachytherapy Balloonsmentioning

confidence: 99%

Endovascular Techniques in Limb Salvage: Cutting, Cryo, Brachy, and Drug-Eluting Balloons

Anaya‐Ayala

2013

Methodist DeBakey Cardiovascular Journal

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Section: Brachytherapy Balloonsmentioning

confidence: 99%

Endovascular Techniques in Limb Salvage: Cutting, Cryo, Brachy, and Drug-Eluting Balloons

Anaya‐Ayala

2013

Methodist DeBakey Cardiovascular Journal

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“…28 Persistent dissection in patients with femoropopliteal obstructive disease treated with PTA plus EVBT has been also described with the use of serial intravascular ultrasound (IVUS). 29 Using noninvasive imaging, we definitively demonstrate that IVUS-detected persistent dissection 29 was not a result of catheter manipulation during the IVUS procedure but was most probably the result of delayed vessel healing after brachytherapy. In addition, by imaging the lesions before the catheter intervention, we demonstrate that in the short term there was no difference in the treatment between the groups, reducing a potential selection bias.…”

Section: Wyttenbach Et Almentioning

confidence: 99%

Effects of Percutaneous Transluminal Angioplasty and Endovascular Brachytherapy on Vascular Remodeling of Human Femoropopliteal Artery by Noninvasive Magnetic Resonance Imaging

et al. 2004

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Background-Percutaneous transluminal angioplasty (PTA) of severely stenotic peripheral vascular lesions is hampered by a higher restenosis rate. The effects of PTA on vascular wall as well as the effects of the antirestenotic properties of endovascular brachytherapy (EVBT) remain unclear. MRI allows in vivo noninvasive assessment of the vascular effects of such treatment strategies. We sought to elucidate the vascular effect of PTA and PTAϩEVBT by serial MRI. Methods and Results-Twenty symptomatic patients with severe stenosis of the femoropopliteal artery were randomly assigned to PTA (nϭ10) or PTAϩEVBT (nϭ10; 14 Gy by ␥-irradiation source) and imaged by high-resolution MRI before and 24 hours and 3 months after intervention. An independent observer blinded to the procedure analyzed the MRI data. At 24 hours, cross-sectional MRI revealed that lumen area (86% and 67%) and total vessel area (47% and 34%) increased similarly in the PTA and PTAϩEVBT groups, respectively. All patients showed severe splitting of the atherosclerotic plaque, resulting in an irregularly shaped lumen. At 3 months, MRI revealed a significant difference in lumen area change between the PTA and PTAϩEVBT groups (40% and 106%, respectively; Pϭ0.026) and in the total vessel area (14% and 39%, respectively; Pϭ0.018). At 3 months, plaque disruption was still present in 50% of the patients treated with PTAϩEVBT. Conclusions-After PTA, there is deep disruption of the atherosclerotic plaques and an extensive remodeling process of the arterial wall. Luminal loss after PTA is partially due to inward vessel remodeling. Brachytherapy prevents inward remodeling and induces an increase in lumen area but partially prevents healing of disrupted vessel surface.

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“…Forty RCTs were accepted into the narrative review, published in 61 references. Study characteristics are shown in Table S1 (supporting information). Most of the trials recruited participants who had angioplasty of the superficial femoral and/or popliteal artery.…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta-analysis of additional technologies to enhance angioplasty for infrainguinal peripheral arterial occlusive disease

Simpson

Michaels

Thomas

et al. 2013

British Journal of Surgery

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Background: There are several additional techniques designed to enhance conventional percutaneous transluminal balloon angioplasty (PTA). This systematic review assessed current evidence on the clinical effectiveness of additional techniques for infrainguinal peripheral arterial occlusive disease (PAD).Methods: Relevant electronic databases, including MEDLINE, were searched in May 2011. The population comprised participants with symptomatic PAD undergoing endovascular treatment for disease distal to the inguinal ligament. Interventions were additional techniques compared with conventional PTA. Main outcome measures were restenosis and need for reintervention. Randomized clinical trials (RCTs) of clinical effectiveness were assessed for quality and data were extracted. Where appropriate, meta-analysis was undertaken to produce risk ratios (RRs).Results: Forty RCTs were selected. Meta-analysis showed a significant benefit in reducing restenosis rates at 6 months for self-expanding stents (RR 0·49) and drug-coated balloons (RR 0·40), and at 12 months for endovascular brachytherapy (RR 0·63). There was also evidence that use of a stent-graft significantly reduced restenosis compared with PTA, as did drug-eluting stents compared with baremetal stents. Meta-analysis showed that use of drug-coated balloons was associated with significantly lower reintervention rates than PTA alone at 6 months (RR 0·24) and 24 months (RR 0·27) of follow-up. There was also evidence of significantly lower reintervention rates for self-expanding stents at 6 months. Other techniques did not show significant treatment effects for restenosis or reintervention. Conclusion:The conclusions of this review should be tempered by small sample sizes, lack of clinical outcome measures and differing outcome definitions, making direct comparison across trials difficult. However, self-expanding stents, drug-eluting stents and drug-coated balloons appeared to be the most promising technologies worthy of future study.

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Gamma radiation induces positive vascular remodeling after balloon angioplasty: A prospective, randomized intravascular ultrasound scan study

Cited by 18 publications

References 32 publications

Endovascular Techniques in Limb Salvage: Cutting, Cryo, Brachy, and Drug-Eluting Balloons

Endovascular Techniques in Limb Salvage: Cutting, Cryo, Brachy, and Drug-Eluting Balloons

Effects of Percutaneous Transluminal Angioplasty and Endovascular Brachytherapy on Vascular Remodeling of Human Femoropopliteal Artery by Noninvasive Magnetic Resonance Imaging

Systematic review and meta-analysis of additional technologies to enhance angioplasty for infrainguinal peripheral arterial occlusive disease

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