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Titolo:
External beam irradiation as an adjunctive treatment in failing dialysis shunts
Autore:
Cohen, GS; Freeman, H; Ringold, MA; Putnam, SG; Ball, DS; Silverman, C; Schulman, G;
Indirizzi:
Temple Univ Hosp, Dept Diagnost Imaging, Philadelphia, PA 19140 USA TempleUniv Hosp Philadelphia PA USA 19140 ng, Philadelphia, PA 19140 USA Temple Univ Hosp, Dept Radiat Oncol, Philadelphia, PA 19140 USA Temple Univ Hosp Philadelphia PA USA 19140 ol, Philadelphia, PA 19140 USA Temple Univ Hosp, Dept Nephrol, Philadelphia, PA 19140 USA Temple Univ Hosp Philadelphia PA USA 19140 ol, Philadelphia, PA 19140 USA
Titolo Testata:
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
fascicolo: 3, volume: 11, anno: 2000,
pagine: 321 - 326
SICI:
1051-0443(200003)11:3<321:EBIAAA>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRACORONARY RADIATION; BALLOON ANGIOPLASTY; NEOINTIMA FORMATION; RESTENOSIS; STENT; PROLIFERATION; INHIBITION; RABBITS; ACCESS;
Keywords:
dialysis, shunts; radiation, therapeutic; restenosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Cohen, GS Temple Univ Hosp, Dept Diagnost Imaging, 3901 N Broad St, Philadelphia, PA19140 USA Temple Univ Hosp 3901 N Broad St Philadelphia PA USA 19140 0 USA
Citazione:
G.S. Cohen et al., "External beam irradiation as an adjunctive treatment in failing dialysis shunts", J VAS INT R, 11(3), 2000, pp. 321-326

Abstract

PURPOSE: To evaluate the utility of low-dose irradiation as adjunctive treatment for failing dialysis shunts related to stenoses. MATERIALS AND METHODS: Thirty-one patients with 41 lesions in their dialysis shunts were successfully enrolled for this study. After imaging of the shunt and calculation of venous stenoses, each patient was randomized into one of two segments of the protocol: (i) angioplasty and/or stent placement alone, and (ii) angioplasty and/or stent placement followed by external beam irradiation. All patients with significant venous stenoses (greater than or equal to 50%) were treated with appropriately sized PTA (percutaneous transluminal angioplasty) and Wallstents. Patients randomized to the externalirradiation segment underwent localized irradiation via a Theratron cobaltunit of 7 Gy 0-24 hours and 24-48 hours after intervention. Those patientsrandomized to the control group received no additional treatment. Clinicalfollow-up included resumption of successful dialysis with appropriate hemodynamic parameters. Two follow-up shunt images were obtained, follow-up 1 (fu-1) from 90 to 179 days and follow-up 2 (fu-2) from 180 to 365 days. Percentages of significant recurrent stenoses, defined as greater than 50%, were recorded and re-treated as needed. RESULTS: Sixteen of the 31 patients underwent external beam irradiation, There were 21 lesions in the test group that underwent irradiation after intervention, and 20 lesions were treated with intervention alone, There were seven native arteriovenous fistulas and 24 Gore-tex grafts. All stenoses were either venous outflow stenoses (68%) or central stenoses (32%). The authors utilized chi(2) analysis to compare restenoses rates between the control and irradiated groups at fu-1 (P < .99) and fu-2 (P < .10),CONCLUSIONS: Although the results show that external beam irradiation has minimal effects on the restenoses of dialysis grafts when used in conjunction with PTA and stent placement, further studies with a larger, more homogenous population are needed to assess the trend of improving patency rates after external beam irradiation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 06:30:56