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J Korean Soc Radiol. 2011 Aug;65(2):119-125. English. Original Article. https://doi.org/10.3348/jksr.2011.65.2.119
Won JY , Lee KH , Lee DY , Kim MS , Kang BC , Kim SJ .
Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea. jywon@yuhs.ac
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology, School of Medicine, Ewha Woman's University, Seoul, Korea.
Department of Internal Medicine, School of Medicine, Ewha Woman's University, Seoul, Korea.
Abstract

PURPOSE: To describe how to make a swine hemodialysis fistula model and report our initial experience to test the feasibility of endovascular radiation therapy with Holmium-166 filled balloon catheters. MATERIALS AND METHODS: The surgical formation of arterio-venous fistula (AVF) was performed by end-to-side anastomosis of the bilateral jugular vein and carotid artery of 6 pigs. After 4 weeks, angiograms were taken and endovascular radiation was delivered to the venous side of AVF with Holmium-166 filled balloon catheters. Pigs were sacrificed 4 weeks after the radiation and AVFs were harvested for histological examination. RESULTS: All animals survived without any morbidity during the experimental periods. The formation of fistula on the sides of necks was successful in 11 of the 12 pigs (92%). One AVF failed from the small jugular vein. On angiograms, 4 of the 11 AVFs showed total occlusion or significant stenosis and therefore, endovascular radiation could not be performed. Of 7 eligible AVFs, five underwent successful endovascular radiation and two AVFs did not undergo radiation for the control. Upon histologic analysis, one non-radiated AVF showed total occlusion and others showed intimal thickening from the neointimal hyperplasia. CONCLUSION: Formation of the swine carotid artery-jugular vein hemodialysis fistula model was successful. Endovascular radiation using a Holmium-166 filled balloon catheter was safe and feasible.

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