ABSTRACT
PURPOSE: Restenosis remains a major problem in percutaneous transluminal angioplasty (PTA) of peripheral arteries. The aim of this feasibility study was to evaluate the technical feasibility and safety of a new endovascular brachytherapy (EVBT) device with Rhenium-188 in restenosis prophylaxis of infrainguinal arteries. MATERIALS AND METHODS: From March 2006 to April 2009, 52 patients with 71 infrainguinal arterial lesions were treated with Re-188 to prevent restenosis after PTA. 40 patients with 53 lesions (24 de-novo lesions and 29 restenoses) were reexamined (clinic, color-coded duplex ultrasound) after a mean follow-up period of 12.7 months (2.6 to 25.1 months). The liquid beta-emitter Re-188 was introduced to the target lesion via an EVBT certified PTA balloon and a tungsten applicator. After the calculated irradiation time, Re-188 was aspirated back into the tungsten applicator. A dose of 13 Gy was applied at a depth of 2 mm into the vessel wall. RESULTS: After a mean follow-up of 12.7 months, the overall restenosis rate after Re-PTA was 15.1 % (8 / 53 lesions). The restenosis rate for de-novo lesions was 20.8 % (5 / 24) and 10.3 % for restenoses (3 / 29). In 4 patients reintervention was necessary (3 PTAs and 2 major amputations). No periprocedural complications were observed. No elevated radiation dose for the patient or the interventionalist was measured. CONCLUSION: EVBT with a Re-188 filled balloon catheter was technically feasible and safe after PTA of infrainguinal arterial lesions with restenosis rates lower than expected compared to published results. Treatment of restenoses seems to be more effective than de-novo lesions.
Subject(s)
Angioplasty, Balloon/instrumentation , Arterial Occlusive Diseases/radiotherapy , Brachytherapy/instrumentation , Ischemia/radiotherapy , Leg/blood supply , Radioisotopes/therapeutic use , Rhenium/therapeutic use , Aged , Aged, 80 and over , Arterial Occlusive Diseases/diagnostic imaging , Feasibility Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Radiotherapy Dosage , Retreatment , Secondary Prevention , Ultrasonography, Doppler, ColorABSTRACT
The bio-psycho-social model was used in the presented study to observe the course of chronic diseases. An attempt was undertaken to correlate the psychosocial situation of 165 women with no presence of disease following breast cancer or genital cancer with their present organic status. The open discussion, a half standardized interview and the gynecological-oncological physical examination were implemented using predetermined parameters. The results of the general well-being scores from the interview and the results of organic status for all 165 patients were related using a rank-correlation between the objective and subjective score. A discrepancy between the psychosocial situation and the objective physical finding was found in the majority of women. The goal of the treatment of chronically ill patients especially following oncological tumors should thus have equal emphasis on the psychosocial and organic dimensions of the disease.
Subject(s)
Adaptation, Psychological , Breast Neoplasms/psychology , Genital Neoplasms, Female/psychology , Psychophysiologic Disorders/psychology , Sick Role , Social Support , Adult , Aged , Breast Neoplasms/pathology , Breast Neoplasms/therapy , Combined Modality Therapy , Female , Follow-Up Studies , Genital Neoplasms, Female/pathology , Genital Neoplasms, Female/therapy , Humans , Middle Aged , Neoplasm Staging , Patient Care Team , Personality Assessment , Psychophysiologic Disorders/therapyABSTRACT
Using freshly poured respectively five days under light and air stored Campylobacter media blood or lignite humic acids containing Mueller-Hinton-Agar proved to be better for isolation of a Campylobacter field strain than unsupplemented or peat humic acids containing media. The observed differences between the used media are probably caused by three different ability to prevent the accumulation of a photochemically induced toxicity by storing of media under light and air. The storage of blood respectively lignite humic acids containing media over fourteen days under dark and air leads to a time and trend dependent decrease of the colony counts of the Campylobacter field strain. By means of equations of spline functions the observed decrease in ability of media to support the growth of thermophilic Campylobacter can be described mathematically. By using the mathematical model the theoretical extend of growth of Campylobacter on the media can be determinate with respect to the applied inoculum and to the time of storage of media. The cause of decrease in the isolations rate with respect to the time of storage and the cause of different effectiveness of the used humic acids in the media are discussed.
