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Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 16, No. 1, 81-83 (2004)
DOI: 10.1177/153100350401600122
© 2004 SAGE Publications

Late Acute Thrombotic Occlusion After Endovascular Brachytherapy and Stenting of Femoropopliteal Arteries

Anton N. Sidawy, MD

Veterans Affairs Medical Center, Washington, DC; MPH, 50 Irving Street, N.W. (112), Washington, DC 20422; ansidawy{at}aol.com

Jonathan M. Weiswasser, MD

Veterans Affairs Medical Center, Washington, DC

Restenosis after angioplasty ranges from 15% to 50%. Endovascular brachytherapy (EVBT) is a promising modality to reduce restenosis, but late acute thrombotic occlusion (LATO) is reported following EVBT. The authors evaluated a combined prevention strategy on restenosis after percutaneous recanalization of the femoropopliteal arteries comparing EVBT performed immediately after angioplasty and medical prevention using probucol vs placebo. Patients who received stenting and EVBT were treated with clopidogrel following the procedure to reduce the occurrence of LATO. Of the 22 patients who received EVBT after stenting, 6 developed LATO after they reduced clopidogrel. None of the 13 patents with stents and without EVBT and none of the 72 patients who underwent EVBT after simple balloon angioplasty developed LATO. The authors concluded that late thrombotic occlusion occurs after undergoing EVBT that follows percutaneous coronary recanalization and also after stenting of the femoropopliteal arteries. They also note a relationship between stopping clopidogrel and the development of late thrombotic occlusion.

Key Words: brachytherapy • clopidogrel • femoropopliteal


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