Leakage of a liquid 188Re-filled balloon system during intracoronary brachytherapy. A case report

Hausleiter, Jörg; Li, Alex; Makkar, Raj; Berman, D.; Robinson, Adela; Litvack, Frank; Eigler, Neal; Whiting, James S.

doi:10.1016/s1522-1865(00)00042-1

Cited by 21 publications

(3 citation statements)

References 5 publications

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“…Since possible unexpected balloon rupture would result in vascular release of 188 Reperhenate and potential high thyroid and radiation exposure, animal studies evaluated thyroid preblocking and also post rupture displacement of perrhenate. These studies demonstrated that prophylactic pre-blocking with iodide (Lugol's) [136] and post thyroid displacement of 188 Re-perrhenate with perchlorate [137] effectively protected the thyroid from radiation exposure and one clinical case did report balloon leakage of 188 Re [138]. Preparation and initial clinical evaluation 188 Re-complexes that demonstrate high renal clearance as well as several hydrophilic complexes is another reported approach [139][140][141][142][143][144][145][146][147].…”

Section: Inhibition Of Arterial Re-stenosis Following Pctamentioning

confidence: 99%

“…Of particular importance is an accurate estimate of the dose prescription, which is accomplished with real time use in the catheterization suite of specially developed software using the balloon dimensions and lesion characteristics [148]. Re from a perrhenatefilled balloon study was reported in one clinical case [138] but dosimetric analysis indicated no unacceptable radiation dose had been received. Several studies substantiated that thyroid localization of perrhenate could be blocked and displaced by treatment with Lugol's (NaI, sodium iodide) solution or with perchlorate [136][137].…”

Section: Inhibition Of Arterial Re-stenosis Following Pctamentioning

confidence: 99%

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Important Clinical Applications of 188Rhenium for Radionuclide Therapy

Shinto¹

2017

Int. J. Nucl. Medi. Res.

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Although established clinical utility is of key importance in choosing agents for radionuclide therapy, other key factors include costs and GMP availability of sterile, pyrogen-free, regulatory approved radiopharmaceuticals. No-carrieradded (NCA) 188 Rhenium(188 Re, 16.9 hour half-life; 155 keV gamma emission) is available on demand as 188 Reperrhenate from saline elution of a 188 Tungsten/ 188 Rhenium(188 W/ 188 Re) generator. The availability and superb radionuclidic and chemical properties make 188 Re an excellent candidate for radionuclide therapy. This radioisotope is readily attached to a variety of targeting agents and also emits high energy beta particles (Emax 2.12 MeV) for therapy. Over the last 30 years the effectiveness of 188 Re for a variety of therapeutic applications has been established in multiple clinical studies. This overview provides a brief summary of clinical applications with 188 Re-labeled agents as an introduction to the detailed clinical discussions in the following papers. Although 188 Re-labeled radiopharmaceuticals for routine clinical use and accompanying reimbursement are not yet commercially available, several agents have been evaluated in clinical studies. In addition, a large number of 188 Re radiopharmaceutical agents have been developed and evaluated in pre-clinical studies over the last three decades. This review focuses on providing examples of 188 Re-labeled radiopharmaceutical agents which have entered late stage clinical use and have demonstrated good efficacy. These key applications include palliative treatment of skeletal metastases, intra-arterial therapy of liver cancer and post PTCA intravascular inhibition of arterial restenosis. Also, 188 Re radiopharmaceuticals had been developed and initially assessed for synovectomy and for marrow suppression. More recently, a unique device-based technology has entered clinical use for therapy of non-melanoma skin cancer using a 188 Re topical cream. Finally, 188 Re-antibodies are being developed for the potential therapy of infectious disease and this unique new therapeutic strategy is expected to enter clinical trials in the near future.

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Section: Inhibition Of Arterial Re-stenosis Following Pctamentioning

confidence: 99%

Section: Inhibition Of Arterial Re-stenosis Following Pctamentioning

confidence: 99%

Important Clinical Applications of 188Rhenium for Radionuclide Therapy

Shinto¹

2017

Int. J. Nucl. Medi. Res.

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“…Although this technique yields desirable dose distribution, the radiological toxicity of the radioactive liquid must be considered, because there is a small risk of balloon rupture or leakage. 11 The generator and handling of the liquid isotope add logistic complexity to the procedure. To minimize the risk of contamination in the event of spillage, ultra-short half-life time isotopes were tested and showed their potential to inhibit neointima formation.…”

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confidence: 99%

Radioactive 133-Xenon Gas-Filled Balloon to Prevent Restenosis

et al. 2002

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Background-Ionizing radiation administered intraluminally via catheter-based systems using solid ␤ and ␥ sources or liquid-filled balloons has shown reduction in the neointima formation after injury in the porcine model. We propose a novel system that uses a 133-Xenon ( 133 Xe) radioactive gas-filled balloon catheter system. Methods and Results-Overstretch balloon injury was performed in the coronary arteries of 33 domestic pigs. A novel 133 Xe radioactive gas-filled balloon (3.5/45 mm) was positioned to overlap the injured segment with margins. After vacuum was obtained in the balloon catheter, Ϸ2.5 cc of 133 Xe gas was injected to fill the balloon. Doses of 0, 7.5, 15, and 30 Gy were delivered to a distance of 0.25 mm from the balloon surface. The dwell time ranged from 1.0 to 4.0 minutes, depending on the dose. Localization of 133 Xe in the balloon was verified by a ␥ camera. The average activity in a 3.5/45-mm balloon was measured at 67.7Ϯ12.1 mCi, and the total diffusion loss of the injected dose was 0.26% per minute of the injected dose. Bedside radiation exposure measured between 2 and 6 mR/h, and the shallow dose equivalent was calculated as 0.

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