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 journalArticle

4 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)53-60
Number of pages8
JournalRadiation Research
Volume156
Issue number1
DOIs
StatePublished - Jan 1 2001

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dialysis
dogs
Dialysis
radiation therapy
safety
Radiotherapy
apoptosis
antigens
Transplants
Safety
Hyperplasia
thrombosis
smooth muscle
wound healing
muscle cells
Nuclear Antigens
irradiation
histology
angiography
polytetrafluoroethylene

ASJC Scopus subject areas

  • Biophysics
  • Radiation
  • Radiology Nuclear Medicine and imaging

Cite this

External-beam radiation therapy for improved dialysis access patency : Feasibility and early safety. / Rectenwald, J. E.; Pretus, H. A.; Seeger, J. M.; Huber, T. S.; Mendenhall, N. P.; Zlotecki, R. A.; Palta, J. R.; Zuo Feng Li, Feng Li; Hook, S. Y.; Sarac, T. P.; Welborn, M. B.; Klingman, N. V.; Abouhamze, Z. S.; Ozaki, C. K.

In: Radiation Research, Vol. 156, No. 1, 01.01.2001, p. 53-60.

Research output: Contribution to journalArticle

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
Rectenwald, J. E. ; Pretus, H. A. ; Seeger, J. M. ; Huber, T. S. ; Mendenhall, N. P. ; Zlotecki, R. A. ; Palta, J. R. ; Zuo Feng Li, Feng Li ; Hook, S. Y. ; Sarac, T. P. ; Welborn, M. B. ; Klingman, N. V. ; Abouhamze, Z. S. ; Ozaki, C. K. / External-beam radiation therapy for improved dialysis access patency : Feasibility and early safety. In: Radiation Research. 2001 ; Vol. 156, No. 1. pp. 53-60.
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