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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).

View larger version (95K): [in a new window]   Figure 1a. Brachytherapy planning procedure. Spot radiographs of the (a) right (R) and (b) left (L) grafts following Wallstent placement, with dummy seeds in place within the stent-treated segment. Radiopaque seeds allow proper positioning of the radiolucent carrier catheter prior to treatment. Metallic markers to the animal's left represent 1-cm increments.

View larger version (85K): [in a new window]   Figure 1b. Brachytherapy planning procedure. Spot radiographs of the (a) right (R) and (b) left (L) grafts following Wallstent placement, with dummy seeds in place within the stent-treated segment. Radiopaque seeds allow proper positioning of the radiolucent carrier catheter prior to treatment. Metallic markers to the animal's left represent 1-cm increments.

View larger version (134K): [in a new window]   Figure 2a. Photomicrographs of the (a) control and (b) treated grafts 1.5 cm central to the anastomosis. Note the greater neointimal thickness (arrows) in a than in b and the artifacts (*) from the stent wire removal. L = lumen. (Hematoxylin-eosin stain; original magnification, x20.)

View larger version (120K): [in a new window]   Figure 2b. Photomicrographs of the (a) control and (b) treated grafts 1.5 cm central to the anastomosis. Note the greater neointimal thickness (arrows) in a than in b and the artifacts (*) from the stent wire removal. L = lumen. (Hematoxylin-eosin stain; original magnification, x20.)

View larger version (137K): [in a new window]   Figure 3a. Spot radiographs obtained during contrast material injection into grafts at 2 months after radiation therapy in the (a) control side and (b) radiated side. a shows greater stenosis (arrow) and greater overall volume of intimal hyperplasia than does b. R = right.

View larger version (132K): [in a new window]   Figure 3b. Spot radiographs obtained during contrast material injection into grafts at 2 months after radiation therapy in the (a) control side and (b) radiated side. a shows greater stenosis (arrow) and greater overall volume of intimal hyperplasia than does b. R = right.