WESTPORT, CT (Reuters Health) - The addition of endovascular brachytherapy to femoropopliteal angioplasty appears to prevent restenosis, according to a report by researchers from the University of Vienna, Austria.

"Right now, we have only seen patients for 2 years, so we don't have long-term results," principal investigator Dr. Erich Minar told Reuters Health in September at the American Society of Therapeutic Radiology and Oncology meeting in New York. But he predicted at that time that brachytherapy for peripheral lesions will become the standard of care in the not-too-distant future. (See Reuters Health report, September 9.)

A report in the November 28th issue of Circulation: Journal of the American Heart Association presents the detailed findings of the study. Dr. Minar and his colleagues studied 113 patients with femoropopliteal lesions, of whom 57 were randomized to brachytherapy after percutaneous transluminal angioplasty (PTA) and 56 underwent PTA only.

On 6-month follow-up, the researchers found that restenosis had occurred in 15 of 53 patients who received brachytherapy, compared with 29 of 54 patients in the PTA-only group. At 12 months, Dr. Minar's group reports, the cumulative patency rates were 63.6% in the brachytherapy group and 35.3% in the PTA-only group.

Noting that claudication can be life-altering, if not life-threatening, Dr. Paul S. Teirstein from Scripps Clinic, La Jolla, California, foresees in an accompanying editorial that "if ongoing trials duplicate the results of the present study, internists, vascular surgeons, radiologists, and cardiologists will have to reevaluate their [conservative] approach to patients with claudication."

He reports that nonradioactive approaches to restenosis will soon be tested, including drug-releasing stents, sonotherapy, and photodynamic therapy. "With this all-fronts attack...the promise of angioplasty may finally be fulfilled for many of our patients."

(From Reuters)