Skip to main content
SpringerLink
Log in
Book cover

Kardiovaskuläre Strahlentherapie pp 247–257Cite as

Perkutane Strahlenbehandlung zur Prophylaxe der frühen Restenose nach PTA±Stent

(Literaturübersicht und Ergebnisse einer Phase III-Studie)

  • Chapter

  • 39 Accesses

Zusammenfassung

Weltweit werden pro Jahr ca. 300000 transluminale Angioplastien durchgeführt. Die prompte Wiedereröffnung des Gefäßes ist allerdings häufig nur von kurzer Dauer. Nach wenigen Monaten treten bei ca. 12–48% aller Patienten Restenosen des diktierten Gefäßabschnitts auf [4, 5, 8]. Ursache für die frühe Restenose ist die sog. „Intimahyperplasie“ [2], welche als überschießender Reparaturversuch der aufgesprengten Gefäßwand anzusehen ist. Diese reparative Hyperproliferation des myofibroblastozytären Apparats findet gleichermaßen auch nach Stentimplantation und operativen Rekonstruktionen statt [11, 14–16, 28].

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   49.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   44.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Abbas MA, Afshari NA, Stadius ML, et al. (1994) External beam irradiation inhibits neointimal hyperplasia following balloon angioplasty. Int J Cardiol 44:191–202

    Article  PubMed  CAS  Google Scholar 

  2. Cox JL, Gottlieb AL (1986) Restenosis following percutaneous transluminal angioplasty: clinical, physiological and pathological features. Can Med Assoc J 134:1129–1132

    CAS  Google Scholar 

  3. Faber LA, Bloch P, Yorke ED, Stevens CW, Herrmann H, Ruffer JE (1999) A dosimetric comparison of conventional vs conformai external beam irradiation of a stented coronary artery utilizing a new fluoroscopic imaging detector system. Cardiovasc Rad Med 1:80–85

    Article  Google Scholar 

  4. Faxon DP, Sandborn TA, Weber VJ (1984) Restenosis following transluminal angioplasty in experimental atherosclerosis. Arteriosclerosis 4:189–195

    Article  PubMed  CAS  Google Scholar 

  5. Faxon DP, Sandborn TA, Haudenschild CC (1987) Mechanism of angioplasty and its relation to restenosis. Am J Cardiol 60:5B–9B

    Article  PubMed  CAS  Google Scholar 

  6. Friedman JR, Burns R (1978) Role of platelets in the proliferative response of the injured artery. Prog Hemost Thromb 4:249–278

    PubMed  CAS  Google Scholar 

  7. Gellman J, Healey G, Qingsheng C, et al. (1991) The effect of very low dose irradiation on restenosis following balloon angioplasty. A study in the atherosclerotic rabbit. Circulation 84:46A–59A

    Google Scholar 

  8. Hehrlein C, Chuang CH, Tuntelder JR, Tatsis GP, Littmann L, Svenson RH (1991) Effects of vascular runoff on myointimal hyperplasia after mechanical balloon or thermal laser arterial injury in dogs. Circulation 84:884–890

    PubMed  CAS  Google Scholar 

  9. Hehrlein C, Kaiser S, Riessen R, Metz J, Fritz P, Kübler W (1999) External beam radiation after stent implantation increases neointimal hyperplasia by augmenting smooth muscle cell proliferation and extracellular matrix accumulation. J Am Coll Cardiol 34:561–566

    Article  PubMed  CAS  Google Scholar 

  10. Hirai T, Korogi Y, Harada M, Takashashi M (1994) Intimal hyperplasia in an atherosclerotic model: prevention with radiation therapy. Radiology 872 (Abstract)

    Google Scholar 

  11. Imparato AM, Bracco A, Kimm GE, Zeff R (1972) Intimal and neointimal fibrous proliferation causing failure of arterial reconstructions. Surgery 172:1007–1017

    Google Scholar 

  12. Leung DYM, Glagov S, Matthews MB (1976) Cyclin stretching stimulates synthesis of matrix components by arterial smooth muscle cells, in vitro. Science 191:475–477

    Article  PubMed  CAS  Google Scholar 

  13. Liermann D, Schopohl B, Herrmann G, Kollath J, Böttcher HD (1992) Endovaskuläres Afterloading als Therapiekonzept zur Prophylaxe der intimalen Hyperplasie in peripheren Gefäßen nach Stentimplantation. In: Kollath J, Liermann D (Hrsg) Stents 2. Schnetztor-Verlag, Konstanz, S 80–92

    Google Scholar 

  14. Liermann D, Böttcher HD, Kollath J, Schopohl B, Strassmann G, Strecker EP, Breddin KH (1994) Intimal hyperplasia after stent implantation in peripheral arteries: treatment by endovascular afterloading. J Cardiovasc Intervent Radiol 17:12–16

    Article  CAS  Google Scholar 

  15. Liermann D, Berkefeld J, Herrmann G, Schopohl B, Strassmann G, Adamitz I, Kollath J (1994) Intervention und Klinik im Zusammenhang mit der endovaskulären Radiatio intimaler Hyperplasien im Gefäßsystem. Radiologic 34:524–533

    CAS  Google Scholar 

  16. Liu MW, Roubin GS, King SB (1989) Restenosis after coronary angioplasty. Potential biologic determinants and rose of intimal hyperplasia. Circulation 79:1374–1387

    Article  PubMed  CAS  Google Scholar 

  17. Mayberg MR, Luo Z, London S, Gajdusek C, Rasey JS (1995) Radiation inhibition of intimal hyperplasia after arterial injury. Radiat Res 142:424–428

    Article  Google Scholar 

  18. Minar E, Pokrajac B, Maca T, Ahmadi R, Fellner C, Mittlböck M, Seitz W, Wolfram R, Pötter R (2000) Endovascular brachytherapy for prophylaxis of restenosis after femoropoliteal angioplasty. Results of a prospective randomized study. Circulation 28:2694–2699

    Google Scholar 

  19. Mosseri M, Schwalb H, Weshler Z (1999) Prevention of restenosis by external beam ionizing irradiation. J Intervent Cardiol 12:283–290

    Article  Google Scholar 

  20. Order SE, Donaldson SS (1990) Radiation therapy of benign diseases. Springer, Berlin Heidelberg New York London Paris Hong Kong

    Google Scholar 

  21. Palmaz JC, Windeler SA, Garcia F (1986) Atherosclerotic rabbit aortas: expandable intraluminal grafting. Radiology 160:723–726

    PubMed  CAS  Google Scholar 

  22. Pokrajac B, Pötter R, Maca T, Fellner C, Mittlböck M, Ahmadi R, Seitz W, Minar E (2000) Intraarterial 192Ir high-dose-rate brachyherapy for prophylaxis of restenosis after femoropopliteal percutaneous transluminal angioplasty: The prospective randomized Vienna-2-trial radiotherapy parameters and risk factors analysis. Int J Radiat Oncol Biol Phys 48 (No 4):923–931

    Article  PubMed  CAS  Google Scholar 

  23. Robinson KA, Verheye S, Salame MY, Marijianowski M, Cui J, Chronos N, King SB, Crocker IR (1999) External radiation for restenosis. J Intervent Cardiol 12:235–241

    Article  Google Scholar 

  24. Roeren T, Palmaz JC, Garcia O, Rees CR, Tio FO (1990) Percutaneous vascular grafting with a coated stent. Radiology 177:202

    Google Scholar 

  25. Rollins N, Weight KC, Charsangavej C, Gianturco C (1987) Selfexpanding metallic stents: preliminary evaluation in an atherosclerotic model. Radiology 163:739–742

    PubMed  CAS  Google Scholar 

  26. Schwartz RS, Kovall TM, Edwards WD, Camrud AR, Baily KR, Browne K, Vlietstra RE, Holmes DR (1992) Effect of external beam irradiation on neointimal hyperplasia after experimental coronary artery injury. J Am Coll Cardiol 19:1106–1113

    Article  PubMed  CAS  Google Scholar 

  27. Simons A (1930) Zur Therapie der Keloide und Narbenhypertrophien. Strahlentherapie 37:89–123

    Google Scholar 

  28. Steidle B (1994) Präventive perkutane Strahlentherapie zur Vermeidung von Intimahyperplasie nach Angioplastie mit Stentimplantation. Strahlenther Onkol 170:151–154

    PubMed  CAS  Google Scholar 

  29. Strecker EP, Hagen B, Liermann D, Kuhn FP (1993) Komplikationen bei der Implantation arterieller Tantalstents und deren Behandlung. Zentralbl Radiol 147:799

    Google Scholar 

  30. Weshler Z, Gotsman MS, Okon E, et al. (1988) Inhibition by irradiation of smooth muscle cell proliferation in the deendothelialized rat aorta. Frontiers in radiation biology: proceedings of the 21st Annual Meeting of the European Society for Radiation Biology. VCH Publishers, New York, pp 133–138

    Google Scholar 

  31. Weshler Z, Zilberman S, Uretsky G, et al. (1992) Radiation effect on vascular intima proliferation following an iatrogenic injury to the endothelium: an experimental study. Med Radiol 67:23–27

    Google Scholar 

Download references

Authors
  1. Peter Fritz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Uwe Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Pritsch
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Abteilung für Kardiologie und Angiologie, Medizinische Universitätsklinik III, Hugstetter Str. 55, 79106, Freiburg, Deutschland

    Christoph Hehrlein

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Steinkopff Verlag Darmstadt

About this chapter

Cite this chapter

Fritz, P., Stein, U., Pritsch, M. (2002). Perkutane Strahlenbehandlung zur Prophylaxe der frühen Restenose nach PTA±Stent. In: Hehrlein, C. (eds) Kardiovaskuläre Strahlentherapie. Steinkopff. https://doi.org/10.1007/978-3-642-96011-6_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-96011-6_14

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-7985-1341-9

  • Online ISBN: 978-3-642-96011-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation