Kombinierte intraduktale und perkutane Radiotherapie bei maligner Gallenwegsobstruktion mit anschließender prothetischer Versorgung

Brambs, H.-J.; Freund, Ulrich; Bruggmoser, G.; Wannenmacher, M.

doi:10.1159/000216378

Cited by 4 publications

(3 citation statements)

References 12 publications

(12 reference statements)

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“…Interarterial aflerloading therapy became possib[e because the diameter of the afterloading probes had been considerably reduced during further development of this treatment for malignant growths in the biliary tract [7]. In contrast to percutaneous irradiation which has to be applied in a fractionated forro to avoid severe side effeets to the surrounding tissue, the endovascular afterloading method reches the same effect in the vascular wall with only a single applicatiou lasting 200 seconds with a strong dose decrease for the surrounding tissue.…”

Section: Discussionmentioning

confidence: 99%

“…The good results obtained in treating keloids by means of irradiation therapy [3,13,14,16,21,28,42,44,49,59,69,78] was the basis for our therapeutic concept for the prophylactic irradiation of hyperproliferative vascular wall reactions. The development of small-caliber probes for afterloading therapy in the biliary tract [7] altowed us to use these for therapy in ~tle vascular system. Together with the initiator of these afterloading method, H. D. BOttcher, our considerations were converted into a clinical trial.…”

Section: Liermann D Et Al Brachytherapy To Prevem From Restenosis mentioning

confidence: 99%

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Brachytherapy with iridium-192 HDR to prevent from restenosis in peripheral arteries

Liermann

Kirchner

Bauernsachs

et al. 1998

Herz

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The use of stents does not appreciably improve restenosis (usually resulting from intimal hyperplasia) as compared to percutaneous transluminal angioplasty (PTA) alone. The development of small-caliber probes for afterloading therapy in the biliary tract allowed us to use these for therapy in the vascular system. Using a special 9 F catheter, exact measurement of the length of the stented vascular segment and of the insertion length of the afterloading probe could be reproducibly performed. We used a Nucletron (Micro) Selectron HDR planning system version 10.10 for exact calculation, monitoring, and control of the afterloading procedure. Our source was iridium 192 (10 Ci) with a diameter of 1.1 mm. The program controls and monitors the insertion and removal of the iridium probe from the source into the special catheter through to the tip, and monitors the irradiation duration. The exposure time was around 200 seconds for a surface dose of 12 Gy. To date, a total of 40 patients have been treated with endovascular afterloading. All patients suffered from clinically relevant reocclusions or restenoses in stented vascular segments of the superficial femoral artery following successful PTA or laser treatment, within 6 to 8 months after the last therapy. In all patients it was possible to perform re-PTA treatment without remaining residual stenoses in the stented region. The additional time required as compared to PTA alone was approximately 45 minutes with most of this time spending for transportation between the cath lab and afterloading room. The follow-up period of the 40 patients ranged from 4 months to 71/2 years. In 33 patients, there was no deterioration of the clinical stage and no restenosis. One patient suffered from an acute thrombosis approximately 3 months after stent implantation, another patient had a stenosis 3 cm above the stented vascular segment 12 months after irradiation treatment. Follow-up examinations have revealed no evidence of nerve lesions following irradiation therapy. The tissue surrounding the artery showed no change following irradiation therapy, either in the CT, color-coded Doppler, endovascular ultrasonic scan or MRI. No complaints of discomfort were reported during or after irradiation. With the exceptions mentioned above, there was no evidence of any complications.

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Section: Discussionmentioning

confidence: 99%

Section: Liermann D Et Al Brachytherapy To Prevem From Restenosis mentioning

confidence: 99%

Brachytherapy with iridium-192 HDR to prevent from restenosis in peripheral arteries

Liermann

Kirchner

Bauernsachs

et al. 1998

Herz

View full text Add to dashboard Cite

show abstract

“…We discussed our therapeutic concept and any alternatives in detail with the patients. Intraarterial afterloading therapy was feasible as small caliber sources were available from developments made for malignant lesions of the bile duct [29].…”

Section: Discussionmentioning

confidence: 99%