Brachytherapy for the prevention of stenosis in a canine hemodialysis graft model: Preliminary observations

Scott O. Trerotoia, Timothy J. Carmody, Robert D. Timmerman, Kathleen Ann Bergan, R. Gerald Dreesen, Stephanie V. Frost, Mitchell Forney

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)748-754
Number of pages7
JournalRADIOLOGY
Volume212
Issue number3
StatePublished - Sep 1 1999

Keywords

  • Animals
  • Dialysis, shunts
  • Grafts, interventional procedures
  • Grafts, stenosis or thrombosis
  • Iridium, radioactive

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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