External beam radiation therapy reduces the rate of re-stenosis in patients treated with femoral stenting: results of a randomised study

Cryoplasty Versus Conventional Balloon Angioplasty of the Femoropopliteal Artery in Diabetic Patients: Long-Term Results from a Prospective Randomized Single-Center Controlled Trial

“…Long-term primary patency probability rates of almost 60% in both groups (59% in group CRYO vs. 55% in group COBA at 3 years) are similar to previously published data of endovascular SFA treatment [10,11,13,14,29]. We believe that these results are in line with the fact that the majority of the included patients suffered from severe intermittent claudication as well as high TASC grade and increased calcification of the treated lesions [10,11,37].…”

“…Low primary patency and increased repeat intervention rates, mainly due to vascular restenosis by means of intimal hyperplasia and negative vessel wall remodelling, has orientated modern cardiovascular research toward new alternative techniques, such as atherectomy, laser-assisted angioplasty, covered stent-grafts, brachytherapy, and cryoplasty [12][13][14]. Of note, there is no controlled evidence in the literature regarding percutaneous therapies of the femoropopliteal artery in the setting of DM apart from single-center patient cohorts [15].…”

Results of a randomized clinical trial of external beam radiation to prevent restenosis after superficial femoral artery stenting

“…experience, EBR did not prevent restenosis in the stented segment. [12][13][14] Absence of EBR efficacy to prevent in-stent restenosis could have been explained by a greater number of stent occlusions in the EBR group than in the placebo group. However, the in-stent binary restenosis, maximal percentage of stenosis, MLD, and LLL were not improved in the EBR group even when all acute stent thromboses were excluded from the analysis.…”

“…Despite these advantages, the experience with EBR to prevent restenosis in peripheral vascular diseases, with various doses and fractions, is limited and contradictory. 9,[11][12][13][14] A dosefinding trial demonstrated that 14 Gy of EBR was effective in reducing restenosis after PTA of SFA lesions, but its effectiveness after stenting of longer lesions has never been demonstrated. 9 Therefore, the objective of this study was to evaluate the safety and efficacy of EBR in preventing restenosis after SFA stenting in comparison with a control group treated with SFA stenting only.…”

Current Approach to the Diagnosis and Treatment of Femoral-Popliteal Arterial Disease. A Systematic Review

“…At 1 year follow-up, a single session of external beam radiation with 14 Gy of the femoropopliteal angioplasty site significantly reduced angiographic restenosis compared to the control and the lower-dose groups [126]. At the short-term, EBR was also shown to decrease restenosis rates in patients with SFPA disease treated with stents, with a lower incidence of thrombotic events than EVBT [127]. However, the late “catch –up” phenomenon observed with EVBT necessitates a longer follow-up to determine the potential benefit of external-beam radiation.…”