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University of Cincinnati Academic Health Center
Publish Date: 07/31/02
Media Contact: AHC Public Relations, (513) 558-4553
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Treatment to Keep Open Dialysis Access Graft Studied

Cincinnati--The University of Cincinnati (UC) Medical Center is the first center in the world to treat a patient with a radioactive seed device that helps doctors clear an intravenous tube in their arm or leg, called a dialysis access graft. Patients with advanced kidney disease need the dialysis access graft so they can be connected to a dialysis machine to clean the blood of toxins and impurities. Grafts are placed in patients who require frequent dialysis to survive. Unfortunately, these grafts are extremely prone to a narrowing, caused by cells attaching themselves to the walls of the graft tubing, called stenosis. "This is a huge problem for patients on dialysis and results in multiple admissions to hospital with a consequent deterioration in their quality of life," said Prabir Roy-Chaudhury, MD, PhD, associate professor of medicine in the Division of Nephrology and Hypertension/Internal Medicine at the UC College of Medicine and The University Hospital.

Dr. Roy-Chaudhury is the lead investigator of a clinical trial to test the radioactive seed device called BRAVO (Beta Radiation for treatment of Arterial-Venous graft Outflow), which is being conducted at more than 20 medical centers in North America and Europe. "The cost of placing and keeping these grafts open is over one billion dollars each year," Dr. Roy-Chaudhury said. The purpose of this trial is to determine how effectively and safely the interventional device made by the Novoste Corporation keeps the graft open. Preliminary tests have shown that when the new device is inserted intravenously for a few minutes, the radiation from the seeds inhibits the narrowing and may keep the graft clear for longer periods of time.

"The first patient we enrolled in the BRAVO trial was a 49-year-old female from Dialysis Clinic, Inc. with end-stage renal disease," said Darryl Zuckerman, MD, associate professor of radiology at the UC Medical Center. The patient received a dialysis graft last August and had required two previous angioplasty procedures to relieve the blockage in this graft. "Following her third angioplasty procedure, we treated her by inserting the new radioactive seed device into the in graft," Dr. Zuckerman said.

"This therapy has the potential to be a significant breakthrough for graft survival in patients whose lives depend on good dialysis access," Dr. Zuckerman said. More than 230,000 Americans and approximately 2,000 Tristate residents are kidney failure patients who depend on dialysis to survive.

"I'm delighted that we have initiated this study and hope that new interventions, such as radiation therapy delivered inside the blood vessel, will improve the quality of life of our patients. If it works as well as anticipated, it may also reduce the huge economic costs associated with this condition," Dr. Roy-Chaudhury said. The UC research team also includes William Barrett, MD, assistant professor of radiation oncology; Howard Elson, PhD, field service professor of radiology; Brian McGill, MS, medical physicist; Heather Duncan, PhD, senior research associate and clinical trial coordinator; and Jeri Foley, RN, MSN, clinical nurse specialist.

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