使用充二氧化碳的中心导管进行β血管内近距离放射治疗复发性股腘浅动脉疾病。

Beta endovascular brachytherapy using CO2-filled centering catheter for treatment of recurrent superficial femoropopliteal artery disease.

作者信息

Pokrajac Boris, Kirisits Christian, Schmid Rainer, Schillinger Martin, Berger Daniel, Peer Katarina, Tripuraneni Prabhakar, Pötter Richard, Minar Erich

机构信息

Department of Radiotherapy, Medical University of Vienna, Vienna General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria.

出版信息

Cardiovasc Revasc Med. 2009 Jul-Sep;10(3):162-5. doi: 10.1016/j.carrev.2009.02.005.

DOI:10.1016/j.carrev.2009.02.005

PMID:19595397

Abstract

BACKGROUND

Recurrent disease (restenosis) after endovascular treatment of the superficial femoral artery (SFA) remains a major problem. We evaluated the efficacy of beta-endovascular brachytherapy using the CORONA centering catheter in patients with SFA restenosis in a single-arm Phase II trial.

METHODS AND RESULTS

A total of 28 patients (mean age 70 years; 16 female, 12 male) with recurrent SFA stenosis were treated, and in-stent restenosis was present in 17 patients (61%). Brachytherapy was performed with strontium-90 beta source using a 7-French CO(2)-filled one-segment centering catheter. New stents had to be applied in two cases. Mean interventional length was 129 mm (range 20-240 mm). A dose of 14 Gy in vessel radius (postinterventional) plus 2 mm was applied in 24 patients and 18.4 Gy in four patients. Treatment time was 7 min 32 s per radiation segment. No major adverse events occurred. Patients were followed by ankle-brachial index and duplex sonography for a median of 42 months. Cumulative restenosis rates at 1, 2, and 3 years were 9%, 28%, and 40%, respectively. Target vessel revascularization was performed in seven cases (25%).

CONCLUSIONS

In comparison to literature data, the treatment of SFA restenosis with beta brachytherapy may improve long-term patency.

摘要

背景

股浅动脉（SFA）血管内治疗后的复发性疾病（再狭窄）仍然是一个主要问题。在一项单臂II期试验中，我们评估了使用CORONA中心导管进行β血管内近距离放射治疗对SFA再狭窄患者的疗效。

方法和结果

共治疗了28例复发性SFA狭窄患者（平均年龄70岁；女性16例，男性12例），其中17例（61%）存在支架内再狭窄。使用7法国CO₂填充的单节段中心导管，以锶-90β源进行近距离放射治疗。有两例患者需要植入新的支架。平均介入长度为129毫米（范围20-240毫米）。24例患者在血管半径（介入后）加2毫米处给予14 Gy的剂量，4例患者给予18.4 Gy的剂量。每个放射节段的治疗时间为7分32秒。未发生重大不良事件。通过踝肱指数和双功超声对患者进行了中位时间为42个月的随访。1年、2年和3年的累积再狭窄率分别为9%、28%和40%。7例（25%）患者进行了靶血管血运重建。