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Titolo:
External-beam radiation therapy for improved dialysis access patency: Feasibility and early safety
Autore:
Rectenwald, JE; Pretus, HA; Seeger, JM; Huber, TS; Mendenhall, NP; Zlotecki, RA; Palta, JR; Li, ZF; Hook, SY; Sarac, TP; Welborn, MB; Klingman, NV; Abouhamze, ZS; Ozaki, CK;
Indirizzi:
Univ Florida, Coll Med, Dept Surg, Gainesville, FL 32610 USA Univ FloridaGainesville FL USA 32610 ept Surg, Gainesville, FL 32610 USA Malcom Randall Vet Affairs Med Ctr, Gainesville, FL 32610 USA Malcom Randall Vet Affairs Med Ctr Gainesville FL USA 32610 FL 32610 USA Univ Florida, Coll Med, Dept Radiat Oncol, Gainesville, FL 32610 USA Univ Florida Gainesville FL USA 32610 at Oncol, Gainesville, FL 32610 USA Univ Florida, Coll Med, Dept Pathol, Gainesville, FL 32610 USA Univ Florida Gainesville FL USA 32610 t Pathol, Gainesville, FL 32610 USA
Titolo Testata:
RADIATION RESEARCH
fascicolo: 1, volume: 156, anno: 2001,
pagine: 53 - 60
SICI:
0033-7587(200107)156:1<53:ERTFID>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
INHIBITS NEOINTIMA FORMATION; ARTERY BALLOON INJURY; INTIMAL HYPERPLASIA; STENT-IMPLANTATION; INTRACORONARY RADIATION; FRACTIONATED-IRRADIATION; PERIPHERAL VESSELS; BETA-IRRADIATION; BRANCH ARTERIES; CANINE MODEL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Ozaki, CK POB 100286, Gainesville, FL 32610 USA POB 100286 Gainesville FLUSA 32610 , Gainesville, FL 32610 USA
Citazione:
J.E. Rectenwald et al., "External-beam radiation therapy for improved dialysis access patency: Feasibility and early safety", RADIAT RES, 156(1), 2001, pp. 53-60

Abstract

Prosthetic dialysis access grafts fail secondary to neointimal hyperplasiaat the venous anastomosis. We hypothesized that postoperative single-fraction external-beam radiation therapy to the venous anastomosis of hemodialysis grafts can be used safely in an effort to improve access patency. Dogs (n = 8) underwent placement of expanded polytetrafluoroethylene grafts from the right carotid artery to the left jugular vein. Five dogs received single-fraction external-beam photon irradiation (8 Gy) to the venous anastomosis after surgery. Controls were not irradiated. Shunt angiograms were completed 3 and 6 months postoperatively. Anastomoses, mid-graft, and the surrounding tissues were analyzed. Immunohistochemistry for smooth muscle cell alpha -actin, proliferating cellular nuclear antigen (PCNA), and apoptosis wasperformed. Incisions healed well, though all animals developed wound seromas. One control suffered graft thrombosis 4 months postoperatively. Angiography/histology confirmed severe neointimal hyperplasia at the venous anastomosis. The remaining seven dogs developed similar amounts of neointinal hyperplasia. PCNA studies showed no accelerated fibroproliferative response atirradiated anastomoses compared to controls. Skin incisions and soft tissues over irradiated anastomoses revealed no radiation-induced changes or increase in apoptosis. Thus we conclude that postoperative single-fraction external-beam irradiation of the venous anastomosis of a prosthetic arteriovenous graft that mimics the situation in humans is feasible and safe with regard to early wound healing. (C) 2001 by Radiation Research Society.

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Documento generato il 28/09/20 alle ore 23:12:12