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Endovascular brachytherapy in peripheral arteries.

E Minar1, B Pokrajac, A Budinsky

  • 1Department of Angiology, University of Vienna, General Hospital Vienna, Austria. erich.minar@akh-wien.ac.at

VASA. Zeitschrift Fur Gefasskrankheiten
|April 8, 2003
PubMed
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Endovascular brachytherapy (BT) significantly improves vessel patency after femoropopliteal angioplasty, reducing restenosis. Further trials are needed, and antithrombotic strategies require optimization to prevent late occlusions.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Radiation Oncology

Background:

  • Restenosis following peripheral angioplasty remains a clinical challenge.
  • Endovascular brachytherapy (BT) is being investigated for restenosis prevention.
  • Limited data exists on BT's efficacy in peripheral versus coronary circulation.

Purpose of the Study:

  • To evaluate the efficacy of endovascular brachytherapy (BT) in preventing restenosis after femoropopliteal angioplasty.
  • To assess the long-term patency rates in patients treated with BT post-angioplasty.

Main Methods:

  • The Vienna 2-Trial was a randomized study comparing percutaneous transluminal angioplasty (PTA) alone versus PTA with endovascular BT.
  • Follow-up included assessment of cumulative patency rates at 12 months and two years.

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Main Results:

  • Endovascular BT significantly improved cumulative patency rates at 12 months (63.6% vs. 35.3%, p < 0.005) compared to PTA alone.
  • This patency benefit was sustained at two-year follow-up.
  • A high incidence of late thrombotic occlusion was observed in long-segment femoropopliteal stenting with BT.

Conclusions:

  • Endovascular BT is effective in preventing restenosis after femoropopliteal angioplasty.
  • Optimization of antithrombotic regimens is crucial for managing late thrombotic occlusions.
  • Results from ongoing trials (PARIS, Vienna 3) are needed for definitive recommendations.