External-beam radiation therapy for improved dialysis access patency: Feasibility and early safety

J. E. Rectenwald; H. A. Pretus; J. M. Seeger; T. S. Huber; N. P. Mendenhall; R. A. Zlotecki; J. R. Palta; Feng Li Zuo Feng Li; S. Y. Hook; T. P. Sarac; M. B. Welborn; N. V. Klingman; Z. S. Abouhamze; C. K. Ozaki

doi:10.1667/0033-7587(2001)156[0053:EBRTFI]2.0.CO;2

External-beam radiation therapy for improved dialysis access patency: Feasibility and early safety

J. E. Rectenwald, H. A. Pretus, J. M. Seeger, T. S. Huber, N. P. Mendenhall, R. A. Zlotecki, J. R. Palta, Feng Li Zuo Feng Li, S. Y. Hook, T. P. Sarac, M. B. Welborn, N. V. Klingman, Z. S. Abouhamze, C. K. Ozaki

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Prosthetic dialysis access grafts fail secondary to neointimal hyperplasia at the venous anastomosis. We hypothesized that postoperative single-fraction external-beam radiation therapy to the venous anastomosis of hemodialysis grafts can be used safely in an effort to improve access patency. Dogs (n = 8) underwent placement of expanded polytetrafluoroethylene grafts from the right carotid artery to the left jugular vein. Five dogs received single-fraction external-beam photon irradiation (8 Gy) to the venous anastomosis after surgery. Controls were not irradiated. Shunt angiograms were completed 3 and 6 months postoperatively. Anastomoses, mid-graft, and the surrounding tissues were analyzed. Immunohistochemistry for smooth muscle cell α-actin, proliferating cellular nuclear antigen (PCNA), and apoptosis was performed. Incisions healed well, though all animals developed wound seromas. One control suffered graft thrombosis 4 months postoperatively. Angiography/histology confirmed severe neointimal hyperplasia at the venous anastomosis. The remaining seven dogs developed similar amounts of neointimal hyperplasia. PCNA studies showed no accelerated fibroproliferative response at irradiated anastomoses compared to controls. Skin incisions and soft tissues over irradiated anastomoses revealed no radiation-induced changes or increase in apoptosis. Thus we conclude that postoperative single-fraction external-beam irradiation of the venous anastomosis of a prosthetic arteriovenous graft that mimics the situation in humans is feasible and safe with regard to early wound healing.

Original language	English (US)
Pages (from-to)	53-60
Number of pages	8
Journal	Radiation research
Volume	156
Issue number	1
DOIs	https://doi.org/10.1667/0033-7587(2001)156[0053:EBRTFI]2.0.CO;2
State	Published - 2001

ASJC Scopus subject areas

Radiation
Biophysics
Radiology Nuclear Medicine and imaging

Access to Document

10.1667/0033-7587(2001)156[0053:EBRTFI]2.0.CO;2

Cite this

Rectenwald, J. E., Pretus, H. A., Seeger, J. M., Huber, T. S., Mendenhall, N. P., Zlotecki, R. A., Palta, J. R., Zuo Feng Li, F. L., Hook, S. Y., Sarac, T. P., Welborn, M. B., Klingman, N. V., Abouhamze, Z. S., & Ozaki, C. K. (2001). External-beam radiation therapy for improved dialysis access patency: Feasibility and early safety. Radiation research, 156(1), 53-60. https://doi.org/10.1667/0033-7587(2001)156[0053:EBRTFI]2.0.CO;2

Rectenwald, JE, Pretus, HA, Seeger, JM, Huber, TS, Mendenhall, NP, Zlotecki, RA, Palta, JR, Zuo Feng Li, FL, Hook, SY, Sarac, TP, Welborn, MB, Klingman, NV, Abouhamze, ZS & Ozaki, CK 2001, 'External-beam radiation therapy for improved dialysis access patency: Feasibility and early safety', Radiation research, vol. 156, no. 1, pp. 53-60. https://doi.org/10.1667/0033-7587(2001)156[0053:EBRTFI]2.0.CO;2

@article{53a16534bf8541efa13f71c53f524ce3,

title = "External-beam radiation therapy for improved dialysis access patency: Feasibility and early safety",

abstract = "Prosthetic dialysis access grafts fail secondary to neointimal hyperplasia at the venous anastomosis. We hypothesized that postoperative single-fraction external-beam radiation therapy to the venous anastomosis of hemodialysis grafts can be used safely in an effort to improve access patency. Dogs (n = 8) underwent placement of expanded polytetrafluoroethylene grafts from the right carotid artery to the left jugular vein. Five dogs received single-fraction external-beam photon irradiation (8 Gy) to the venous anastomosis after surgery. Controls were not irradiated. Shunt angiograms were completed 3 and 6 months postoperatively. Anastomoses, mid-graft, and the surrounding tissues were analyzed. Immunohistochemistry for smooth muscle cell α-actin, proliferating cellular nuclear antigen (PCNA), and apoptosis was performed. Incisions healed well, though all animals developed wound seromas. One control suffered graft thrombosis 4 months postoperatively. Angiography/histology confirmed severe neointimal hyperplasia at the venous anastomosis. The remaining seven dogs developed similar amounts of neointimal hyperplasia. PCNA studies showed no accelerated fibroproliferative response at irradiated anastomoses compared to controls. Skin incisions and soft tissues over irradiated anastomoses revealed no radiation-induced changes or increase in apoptosis. Thus we conclude that postoperative single-fraction external-beam irradiation of the venous anastomosis of a prosthetic arteriovenous graft that mimics the situation in humans is feasible and safe with regard to early wound healing.",

author = "Rectenwald, {J. E.} and Pretus, {H. A.} and Seeger, {J. M.} and Huber, {T. S.} and Mendenhall, {N. P.} and Zlotecki, {R. A.} and Palta, {J. R.} and {Zuo Feng Li}, {Feng Li} and Hook, {S. Y.} and Sarac, {T. P.} and Welborn, {M. B.} and Klingman, {N. V.} and Abouhamze, {Z. S.} and Ozaki, {C. K.}",

year = "2001",

doi = "10.1667/0033-7587(2001)156[0053:EBRTFI]2.0.CO;2",

language = "English (US)",

volume = "156",

pages = "53--60",

journal = "Radiation research",

issn = "0033-7587",

publisher = "Radiation Research Society",

number = "1",

}

TY - JOUR

T1 - External-beam radiation therapy for improved dialysis access patency

T2 - Feasibility and early safety

AU - Rectenwald, J. E.

AU - Pretus, H. A.

AU - Seeger, J. M.

AU - Huber, T. S.

AU - Mendenhall, N. P.

AU - Zlotecki, R. A.

AU - Palta, J. R.

AU - Zuo Feng Li, Feng Li

AU - Hook, S. Y.

AU - Sarac, T. P.

AU - Welborn, M. B.

AU - Klingman, N. V.

AU - Abouhamze, Z. S.

AU - Ozaki, C. K.

PY - 2001

Y1 - 2001

N2 - Prosthetic dialysis access grafts fail secondary to neointimal hyperplasia at the venous anastomosis. We hypothesized that postoperative single-fraction external-beam radiation therapy to the venous anastomosis of hemodialysis grafts can be used safely in an effort to improve access patency. Dogs (n = 8) underwent placement of expanded polytetrafluoroethylene grafts from the right carotid artery to the left jugular vein. Five dogs received single-fraction external-beam photon irradiation (8 Gy) to the venous anastomosis after surgery. Controls were not irradiated. Shunt angiograms were completed 3 and 6 months postoperatively. Anastomoses, mid-graft, and the surrounding tissues were analyzed. Immunohistochemistry for smooth muscle cell α-actin, proliferating cellular nuclear antigen (PCNA), and apoptosis was performed. Incisions healed well, though all animals developed wound seromas. One control suffered graft thrombosis 4 months postoperatively. Angiography/histology confirmed severe neointimal hyperplasia at the venous anastomosis. The remaining seven dogs developed similar amounts of neointimal hyperplasia. PCNA studies showed no accelerated fibroproliferative response at irradiated anastomoses compared to controls. Skin incisions and soft tissues over irradiated anastomoses revealed no radiation-induced changes or increase in apoptosis. Thus we conclude that postoperative single-fraction external-beam irradiation of the venous anastomosis of a prosthetic arteriovenous graft that mimics the situation in humans is feasible and safe with regard to early wound healing.

AB - Prosthetic dialysis access grafts fail secondary to neointimal hyperplasia at the venous anastomosis. We hypothesized that postoperative single-fraction external-beam radiation therapy to the venous anastomosis of hemodialysis grafts can be used safely in an effort to improve access patency. Dogs (n = 8) underwent placement of expanded polytetrafluoroethylene grafts from the right carotid artery to the left jugular vein. Five dogs received single-fraction external-beam photon irradiation (8 Gy) to the venous anastomosis after surgery. Controls were not irradiated. Shunt angiograms were completed 3 and 6 months postoperatively. Anastomoses, mid-graft, and the surrounding tissues were analyzed. Immunohistochemistry for smooth muscle cell α-actin, proliferating cellular nuclear antigen (PCNA), and apoptosis was performed. Incisions healed well, though all animals developed wound seromas. One control suffered graft thrombosis 4 months postoperatively. Angiography/histology confirmed severe neointimal hyperplasia at the venous anastomosis. The remaining seven dogs developed similar amounts of neointimal hyperplasia. PCNA studies showed no accelerated fibroproliferative response at irradiated anastomoses compared to controls. Skin incisions and soft tissues over irradiated anastomoses revealed no radiation-induced changes or increase in apoptosis. Thus we conclude that postoperative single-fraction external-beam irradiation of the venous anastomosis of a prosthetic arteriovenous graft that mimics the situation in humans is feasible and safe with regard to early wound healing.

UR - http://www.scopus.com/inward/record.url?scp=0034954389&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034954389&partnerID=8YFLogxK

U2 - 10.1667/0033-7587(2001)156[0053:EBRTFI]2.0.CO;2

DO - 10.1667/0033-7587(2001)156[0053:EBRTFI]2.0.CO;2

M3 - Article

C2 - 11418073

AN - SCOPUS:0034954389

SN - 0033-7587

VL - 156

SP - 53

EP - 60

JO - Radiation research

JF - Radiation research

IS - 1

ER -

External-beam radiation therapy for improved dialysis access patency: Feasibility and early safety

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this