Brachytherapie zur Restenose-Prophylaxe Nach Peripher-Arteriellen Interventionen

Brachytherapy for prevention of restenosis after endovascular interventions in peripheral arteries. The first applications of intravascular brachytherapy (EVBT) were published in pilot studies after femoro-popliteal angioplasty (PTA) or stent implantation. Controlled studies were performed in coronary arteries demonstrating significant reduction of restenosis rate after PTCA or stenting. The first randomized study published in peripheral arteries from Vienna showed a significant reduction of the six months restenosis rate of 54% to 28% by EVBT (gamma-irradiation by 192Ir) after PTA of mainly de-novo long-segment femoro-popliteal obstructions. These positive results were confirmend in another randomized study from our center on recurrent femoro-popliteal lesions. Also, preliminary analysis of a Swiss multicenter study (PAB) showed significantly positive results after EVBT. Application of higher irradiation doses and centering devices are currently under study. Based on these promising results EVBT may become a practical means for prevention of restenosis after femoro-popliteal PTA.Ir) after PTA of mainly de-novo long-segment femoro-popliteal obstructions. These positive results were confirmend in another randomized study from our center on recurrent femoro-popliteal lesions. Also, preliminary analysis of a Swiss multicenter study (PAB) showed significantly positive results after EVBT. Application of higher irradiation doses and centering devices are currently under study. Based on these promising results EVBT may become a practical means for prevention of restenosis after femoro-popliteal PTA.