PROPHYLACTIC ENDOVASCULAR RADIOTHERAPY TO PREVENT INTIMAL HYPERPLASIA AFTER STENT IMPLANTATION IN FEMOROPOPLITEAL ARTERIES

Purpose: Recurrent stenosis or occlusion by intimal hyperplasia occurs in up to 40% of patients with tantalum stent implantations in femoropopliteal arteries and greatly restricts their usefulness. We evaluated the effect of prophylactic endovascular radiotherapy on stenosed/occluded stents. Methods: We investigated prophylactic endovascular radiotherapy with a surface dose of 12 Gy using an iridium 192 source as a means to reduce or eliminate recurrent stenosis in 4 patients with stenosed/occluded stents, 6-8 months after the original implantation. Confirmatory diagnostic atherectomy, PTA or laser recanalization and endovascular radiotherapy were performed. Results: None of the four has developed recurrent obstruction within 23 to 30 months after this treatment, which up to now shows no short-term or long-term complications. Conclusion: We conclude that this limited experience is promising enough to warrant further study.