Possible impact of iridium-192 source centering on restenosis rate after femoro-popliteal angioplasty and endovascular brachytherapy in Vienna-2 study
(2002) Radiotherapy & Oncology — Vol. 63, n° 1, p. 97-102 (2002)
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- Purpose: Endovascular brachytherapy (EVBT) has been proven to significantly reduce restenosis after percutaneous transluminal angioplasty (PTA). The object of this analysis was to assess the possible correlation between iridium-192 source non-centering and angiographic-determined restenosis. Materials and methods: A total of 113 patients with long-segment lesions of the superficial femoro-popliteal artery (SFA) were randomized to receive either PTA alone or PTA followed by EVBT in the Vienna-2 study. This analysis was performed on a subgroup of 34 out of 57 patients, who received PTA + EVBT. Angiographic restenosis was defined as lumen reduction of more than 50%. Angio.-rams taken immediately after PTA (34 patients) and It follow-up (25 patients) were analyzed. The distance between the vessel wall and the actual position of the source at the time of EVBT was measured (in mm) and correlated with the follow-up vessel lumen diameter. Measurements were performed at points at a distance of 10 mm from each other. The dose was determined at the luminal surface and at the reference depth of 2 mm into the vessel wall for different distances from the source. Results: Among the 622 measured points, 62 (10.0%) were within restenotic areas; 560 (90.0%) were in arterial segments without proven angiographic restenosis, As far as source centering is concerned, 7.9% of restenotic points were observed when the maximum distance to the arterial wall was <3 min and 9.6% for 4 mm, respectively. The percentage of restenotic points increased up to 15.9%, when the maximum distance to the arterial wall was 5 min and reached 22.2% when it was >5 mm. Conclusions: The proportion of restenotic points significantly increased with source non-centering. This observation was interpreted as being related to a decrease in dose at the target. When the maximum distance between the source and the vessel surface was >5 mm, the dose at the reference depth (2 min into the vessel wall) decreased to values lower than 5 Gy. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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Pokrajac, B., Schmid, R., Kirisits, C., Mock, U., Fellner, C., Wambersie, A., Pötter, R., & Minar, E. (2002). Possible impact of iridium-192 source centering on restenosis rate after femoro-popliteal angioplasty and endovascular brachytherapy in Vienna-2 study. Radiotherapy & Oncology, 63(1), 97-102. https://doi.org/10.1016/S0167-8140(02)00018-X (Original work published 2002)