Intravascular brachytherapy for peripheral vascular disease

Therapeutic strategies to combat neointimal hyperplasia in vascular grafts

“…The BRAVO-I trial tested one dose of endovascular radiation delivered to failing dialysis-access grafts and showed improvement in target lesion revascularization, but not in overall patency at 6 or 12 months [55]. Peripheral bypass intravascular brachytherapy for restenosis has been examined in a limited manner, with studies showing no improvement in ankle–brachial index, clinical symptoms or angiographic restenosis with a 5-year follow-up, despite moderate improvement at 6 months [56,57]. Future therapies that are promising include temporary absorbable stents and drug-eluting balloons that can deliver drug therapy but not leave a permanent implant.…”

Endovascular Brachytherapy Using Liquid Beta-Emitting Rhenium-188 for the Treatment of Long-Segment Femoropopliteal In-Stent Stenosis

“…In the literature, there is some evidence that EVBT with gamma irradiation (iridium-192) is effective in preventing recurrent stenosis within the femoropopliteal segment. 13 Gamma irradiation was also investigated in restenotic lesions; a meta-analysis 14 of the Vienna-II and Vienna-III trials 15,16 revealed that EVBT treatment of non-stented restenotic femoral lesions resulted in a 45% reduction in recurrence compared to angioplasty alone. In another study, endovascular gamma irradiation after balloon angioplasty of restenotic femoropopliteal arteries reduced the restenosis rate by 51% at 6 months.…”

DDS

“…Nach der vorliegenden Datenlage stellt die endovaskuläre Brachytherapie das erste wirksame Therapiekonzept zur Vermeidung einer Restenose im peripheren Stromgebiet gerade bei diabetischen Patienten dar [5]. Trotz ihrer inzwischen gesicherten Wirksamkeit [13] …”