Effects of brachytherapy on intimal hyperplasia in arteriovenous fistulas in a porcine model

Victor M Rodriguez, Jay Grove, Susan Yelich, David Pearson, Moni Stein, William C Pevec

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

PURPOSE: The hypotheses of this investigation were that endovascular radiation would reduce intimal hyperplasia in arteriovenous fistulas (AVFs) and that this reduction would be associated with decreased expression of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF)-A, and tumor necrosis factor (TNF)-α. MATERIALS AND METHODS: Bilateral end jugular vein-to-side carotid artery fistulas were constructed in pigs. At 48 hours, one AVF was randomly selected for endovascular radiation with 192Iridium. The contralateral fistula received no radiation and served as a control. Animals in group 1 (n = 7) received 14 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days; animals in group 2 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days (n = 8); and animals in group 3 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 56 days (n = 8). The area and maximum thickness of intimal hyperplasia were then measured blindly. Immunohistochemical results for VEGF, PDGF-A, and TNFα were obtained and analyzed blindly by assigning a score of 0-3, with 0 indicating no staining and 3 indicating maximum staining. RESULTS: Irradiation with 14 Gy caused severe fibrosis in the media of the vein, with thrombosis of three of seven AVFs. Compared with the control group, the group that underwent irradiation with 7 Gy had significantly reduced intimal area at 56 days (9.9 mm2 ± 4.9 vs 2.1 mm2 ± 1.1; P = .001). This reduction correlated with significant reduction in the expression of VEGF (score of 2.2 ± 0.1 vs 1.2 ± 0.2; P = .001) and TNFα (1.3 ± 0.1 vs 0.9 ± 0.1; P = .04). CONCLUSION: Fourteen grays is an excessive radiation dose for veins, causing medial fibrosis and thrombosis of the AVF. Irradiation with 7 Gy effectively inhibited the formation of intimal hyperplasia in AVF. This inhibition correlated with decreased expression of VEGF and TNFα.

Original languageEnglish (US)
Pages (from-to)1239-1246
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume13
Issue number12
StatePublished - Dec 1 2002

Fingerprint

Tunica Intima
Arteriovenous Fistula
Brachytherapy
Hyperplasia
Swine
Radiation Dosage
Vascular Endothelial Growth Factor A
Tumor Necrosis Factor-alpha
Radiation
Fistula
Veins
Thrombosis
Fibrosis
Staining and Labeling
Jugular Veins
Carotid Arteries
Control Groups

Keywords

  • Blood vessels, stenosis or obstruction
  • Brachytherapy
  • Fistula, arteriovenous
  • Intimal hyperplasia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Effects of brachytherapy on intimal hyperplasia in arteriovenous fistulas in a porcine model. / Rodriguez, Victor M; Grove, Jay; Yelich, Susan; Pearson, David; Stein, Moni; Pevec, William C.

In: Journal of Vascular and Interventional Radiology, Vol. 13, No. 12, 01.12.2002, p. 1239-1246.

Research output: Contribution to journalArticle

@article{76a78e74a00a4ef7877601d812558e89,
title = "Effects of brachytherapy on intimal hyperplasia in arteriovenous fistulas in a porcine model",
abstract = "PURPOSE: The hypotheses of this investigation were that endovascular radiation would reduce intimal hyperplasia in arteriovenous fistulas (AVFs) and that this reduction would be associated with decreased expression of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF)-A, and tumor necrosis factor (TNF)-α. MATERIALS AND METHODS: Bilateral end jugular vein-to-side carotid artery fistulas were constructed in pigs. At 48 hours, one AVF was randomly selected for endovascular radiation with 192Iridium. The contralateral fistula received no radiation and served as a control. Animals in group 1 (n = 7) received 14 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days; animals in group 2 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days (n = 8); and animals in group 3 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 56 days (n = 8). The area and maximum thickness of intimal hyperplasia were then measured blindly. Immunohistochemical results for VEGF, PDGF-A, and TNFα were obtained and analyzed blindly by assigning a score of 0-3, with 0 indicating no staining and 3 indicating maximum staining. RESULTS: Irradiation with 14 Gy caused severe fibrosis in the media of the vein, with thrombosis of three of seven AVFs. Compared with the control group, the group that underwent irradiation with 7 Gy had significantly reduced intimal area at 56 days (9.9 mm2 ± 4.9 vs 2.1 mm2 ± 1.1; P = .001). This reduction correlated with significant reduction in the expression of VEGF (score of 2.2 ± 0.1 vs 1.2 ± 0.2; P = .001) and TNFα (1.3 ± 0.1 vs 0.9 ± 0.1; P = .04). CONCLUSION: Fourteen grays is an excessive radiation dose for veins, causing medial fibrosis and thrombosis of the AVF. Irradiation with 7 Gy effectively inhibited the formation of intimal hyperplasia in AVF. This inhibition correlated with decreased expression of VEGF and TNFα.",
keywords = "Blood vessels, stenosis or obstruction, Brachytherapy, Fistula, arteriovenous, Intimal hyperplasia",
author = "Rodriguez, {Victor M} and Jay Grove and Susan Yelich and David Pearson and Moni Stein and Pevec, {William C}",
year = "2002",
month = "12",
day = "1",
language = "English (US)",
volume = "13",
pages = "1239--1246",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "12",

}

TY - JOUR

T1 - Effects of brachytherapy on intimal hyperplasia in arteriovenous fistulas in a porcine model

AU - Rodriguez, Victor M

AU - Grove, Jay

AU - Yelich, Susan

AU - Pearson, David

AU - Stein, Moni

AU - Pevec, William C

PY - 2002/12/1

Y1 - 2002/12/1

N2 - PURPOSE: The hypotheses of this investigation were that endovascular radiation would reduce intimal hyperplasia in arteriovenous fistulas (AVFs) and that this reduction would be associated with decreased expression of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF)-A, and tumor necrosis factor (TNF)-α. MATERIALS AND METHODS: Bilateral end jugular vein-to-side carotid artery fistulas were constructed in pigs. At 48 hours, one AVF was randomly selected for endovascular radiation with 192Iridium. The contralateral fistula received no radiation and served as a control. Animals in group 1 (n = 7) received 14 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days; animals in group 2 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days (n = 8); and animals in group 3 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 56 days (n = 8). The area and maximum thickness of intimal hyperplasia were then measured blindly. Immunohistochemical results for VEGF, PDGF-A, and TNFα were obtained and analyzed blindly by assigning a score of 0-3, with 0 indicating no staining and 3 indicating maximum staining. RESULTS: Irradiation with 14 Gy caused severe fibrosis in the media of the vein, with thrombosis of three of seven AVFs. Compared with the control group, the group that underwent irradiation with 7 Gy had significantly reduced intimal area at 56 days (9.9 mm2 ± 4.9 vs 2.1 mm2 ± 1.1; P = .001). This reduction correlated with significant reduction in the expression of VEGF (score of 2.2 ± 0.1 vs 1.2 ± 0.2; P = .001) and TNFα (1.3 ± 0.1 vs 0.9 ± 0.1; P = .04). CONCLUSION: Fourteen grays is an excessive radiation dose for veins, causing medial fibrosis and thrombosis of the AVF. Irradiation with 7 Gy effectively inhibited the formation of intimal hyperplasia in AVF. This inhibition correlated with decreased expression of VEGF and TNFα.

AB - PURPOSE: The hypotheses of this investigation were that endovascular radiation would reduce intimal hyperplasia in arteriovenous fistulas (AVFs) and that this reduction would be associated with decreased expression of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF)-A, and tumor necrosis factor (TNF)-α. MATERIALS AND METHODS: Bilateral end jugular vein-to-side carotid artery fistulas were constructed in pigs. At 48 hours, one AVF was randomly selected for endovascular radiation with 192Iridium. The contralateral fistula received no radiation and served as a control. Animals in group 1 (n = 7) received 14 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days; animals in group 2 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days (n = 8); and animals in group 3 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 56 days (n = 8). The area and maximum thickness of intimal hyperplasia were then measured blindly. Immunohistochemical results for VEGF, PDGF-A, and TNFα were obtained and analyzed blindly by assigning a score of 0-3, with 0 indicating no staining and 3 indicating maximum staining. RESULTS: Irradiation with 14 Gy caused severe fibrosis in the media of the vein, with thrombosis of three of seven AVFs. Compared with the control group, the group that underwent irradiation with 7 Gy had significantly reduced intimal area at 56 days (9.9 mm2 ± 4.9 vs 2.1 mm2 ± 1.1; P = .001). This reduction correlated with significant reduction in the expression of VEGF (score of 2.2 ± 0.1 vs 1.2 ± 0.2; P = .001) and TNFα (1.3 ± 0.1 vs 0.9 ± 0.1; P = .04). CONCLUSION: Fourteen grays is an excessive radiation dose for veins, causing medial fibrosis and thrombosis of the AVF. Irradiation with 7 Gy effectively inhibited the formation of intimal hyperplasia in AVF. This inhibition correlated with decreased expression of VEGF and TNFα.

KW - Blood vessels, stenosis or obstruction

KW - Brachytherapy

KW - Fistula, arteriovenous

KW - Intimal hyperplasia

UR - http://www.scopus.com/inward/record.url?scp=0036898254&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036898254&partnerID=8YFLogxK

M3 - Article

C2 - 12471188

AN - SCOPUS:0036898254

VL - 13

SP - 1239

EP - 1246

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 12

ER -