Lotun Kapildeo, Soukas Peter, Cho Sung, O'Donnell Kevin, Griben André, Irwin William T, Schainfeld Robert M
Division of Vascular Medicine, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA 02135, USA.
Cardiovasc Revasc Med. 2005 Apr-Jun;6(2):75-81. doi: 10.1016/j.carrev.2005.02.004.
We describe a case of instent restenosis in a femoral-distal saphenous vein bypass graft successfully treated with brachytherapy. A 45-year-old insulin-requiring diabetic woman underwent an in-situ femoral-anterior tibial bypass graft for a non-healing ischemic ulcer. Despite a technically successful percutaneous transluminal angioplasty and endovascular stenting of a retained valve within the threatened graft, the wound failed to heal. At the 1-month follow-up, instent restenosis was documented and successful cutting balloon angioplasty, complemented by adjunctive beta-irradiation was successfully performed. Clinical and hemodynamic success was achieved, with prompt ulcer healing and intermediate-term graft patency maintained on surveillance duplex ultrasound follow-up. We review the literature on radiation therapy in the management of peripheral arterial disease and discuss therapeutic options in the management of restenosis.
我们描述了一例股-远端大隐静脉搭桥移植物内支架再狭窄的病例，该病例通过近距离放射治疗成功治愈。一名45岁需要胰岛素治疗的糖尿病女性因缺血性溃疡不愈合接受了原位股-胫前搭桥手术。尽管经皮腔内血管成形术和对受威胁移植物内保留瓣膜进行血管内支架置入术在技术上取得成功，但伤口仍未愈合。在1个月的随访中，记录到支架内再狭窄，并成功进行了切割球囊血管成形术，并辅以β射线照射。取得了临床和血流动力学成功，溃疡迅速愈合，在监测双功超声随访中维持了中期移植物通畅。我们回顾了关于放射治疗在外周动脉疾病管理中的文献，并讨论了再狭窄管理中的治疗选择。
