Beta radiation in the treatment of in-stent restenosis of an in situ saphenous vein bypass graft: A case report

Kapildeo Lotun, Peter Soukas, Sung Cho, Kevin O'Donnell, André Griben, William T. Irwin, Robert M. Schainfeld

Research output: Contribution to journalArticle

Abstract

We describe a case of instent restenosis in a femoral-distal saphenous vein bypass graft successfully treated with brachytherapy. A 45-year-old insulin-requiring diabetic woman underwent an in-situ femoral-anterior tibial bypass graft for a non-healing ischemic ulcer. Despite a technically successful percutaneous transluminal angioplasty and endovascular stenting of a retained valve within the threatened graft, the wound failed to heal. At the 1-month follow-up, instent restenosis was documented and successful cutting balloon angioplasty, complemented by adjunctive beta-irradiation was successfully performed. Clinical and hemodynamic success was achieved, with prompt ulcer healing and intermediate-term graft patency maintained on surveillance duplex ultrasound follow-up. We review the literature on radiation therapy in the management of peripheral arterial disease and discuss therapeutic options in the management of restenosis.

Original languageEnglish (US)
Pages (from-to)75-81
Number of pages7
JournalCardiovascular Revascularization Medicine
Volume6
Issue number2
DOIs
StatePublished - Jan 1 2005
Externally publishedYes

Keywords

  • Instent restenosis
  • PTA
  • Peripheral arterial disease
  • Vascular irradiation
  • Venous bypass graft

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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