[Preventive percutaneous radiotherapy for avoiding hyperplasia of the intima following angioplasty together with stent implantation].

PURPOSE AND BACKGROUND

Interventional radiologic procedures play an important role in the management of peripheral arterial occlusive disease. Percutaneous transluminal interventions as angioplasty (PTA) and implantations of metal-stents injure the wall of the blood vessels resulting in hyperplasia of the intima and media. In spite of adequate anticoagulation therapy restenosis and reocclusion frequently occur. Our study was designed to prevent hyperplasia of the intima by percutaneous radiation therapy.

PATIENTS AND METHODS

A total of 24 patients had a stent implanted in their superficial femoral artery from 1990 to 1992. Eleven patients received percutaneous radiation therapy of the enlarged stent area on five consecutive days with a single dose of 2.5 Gy thus resulting in a total dose of 12.5 Gy. Both patients groups were compared. None of the patients in the radiation group suffered from complications.

RESULTS

In the seven months following stent implantation and radiation only two of eleven patients in the radiation group suffered from occlusion of the stent that had to be treated by vascular surgery. In comparison five of 13 patients treated with stent implantation alone suffered from occlusion of the stent within the first eight to nine months.

CONCLUSION

In spite of a small case number our study shows a positive influence of percutaneous radiation therapy on the extent of hyperplasia of the intima after stent implantation leading to lower reocclusion rates. Whether these results can be improved by alternative dose-fractionation schedules has to be addressed by further studies.