HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Trerotola, S. O. Articles by Forney, M. Search for Related Content PubMed PubMed Citation Articles by Trerotola, S. O. Articles by Forney, M.

Brachytherapy for the Prevention of Stenosis in a Canine Hemodialysis Graft Model: Preliminary Observations¹

¹ From the Departments of Radiology (S.O.T., T.J.C., R.G.D.), Radiation Oncology (R.D.T., S.V.F.), Medicine (K.A.B.), and Surgery (M.F.), Indiana University Medical Center, UH0279, 550 N University Blvd, Indianapolis, IN 46202-5253. From the 1998 RSNA scientific assembly. Received July 8, 1998; revision requested August 6; revision received November 23; accepted February 16, 1999. Address reprint requests to S.O.T. (e-mail: streroto@iupui.edu).

PURPOSE: To determine whether gamma brachytherapy can prevent in-stent stenosis in hemodialysis grafts.

MATERIALS AND METHODS: Six-millimeter polytetrafluoroethylene arteriovenous grafts were created bilaterally in six dogs. After 1 month, Wallstents spanning the venous anastomosis were placed to accelerate restenosis. Gamma irradiation (12 Gy) was delivered endoluminally to one of the two grafts by using an iridium 192 source; thus, each animal served as its own control. Fistulography was performed monthly for 10 months or until graft thrombosis, with measurement of stenosis at each time point. At the conclusion of the study period, the treated area was examined histologically, and a computer model was used to calculate the volume of intimal hyperplasia.

RESULTS: Delayed stent migration resulted in exclusion of one dog. In the remaining five dogs, maximum stenosis across all time intervals was less for the treated side (P < .04), and the volume of intimal hyperplasia was less for the treated side (P < .045). In one animal studied at 1 year, this trend reversed in terms of percentage stenosis but not total neointimal volume.

CONCLUSION: Brachytherapy with ¹⁹²Ir (gamma) delivered at the time of stent placement reduces restenosis in this hemodialysis graft model, but, depending on the parameter evaluated (stenosis vs total volume of neointima), the benefit may wane or even reverse with time.

Index terms: Animals • Dialysis, shunts, 80.42, 92.457, 93.457 • Grafts, interventional procedures, 92.1268, 93.1268 • Grafts, stenosis or thrombosis, 92.1268, 92.458, 93.1268, 93.458 • Iridium, radioactive

This article has been cited by other articles:

				Y. Wang, M. Krishnamoorthy, R. Banerjee, J. Zhang, S. Rudich, C. Holland, L. Arend, and P. Roy-Chaudhury Venous stenosis in a pig arteriovenous fistula model--anatomy, mechanisms and cellular phenotypes Nephrol. Dial. Transplant., February 1, 2008; 23(2): 525 - 533. [Abstract] [Full Text] [PDF]

				C. M. Terry, D. K. Blumenthal, S. Sikharam, L. Li, T. Kuji, S. E. Kern, and A. K. Cheung Evaluation of histological techniques for quantifying haemodialysis arteriovenous (AV) graft hyperplasia Nephrol. Dial. Transplant., November 1, 2006; 21(11): 3172 - 3179. [Abstract] [Full Text] [PDF]

				S. O. Trerotola and L. A. Turmel-Rodrigues Off the Beaten Path: Transbrachial Approach for Native Fistula Interventions Radiology, March 1, 2001; 218(3): 617 - 619. [Full Text]