Feasibility of external beam radiation for prevention of restenosis following balloon angioplasty.

PURPOSE: Brachytherapy has been shown to inhibit neointima formation after vascular balloon injury. This study was done to test the feasibility of low dose external radiation for prevention of restenosis in a non-stented balloon injury model. MATERIALS AND METHODS: Twelve red Duroc swine underwent balloon overdilation injury of both iliac arteries. Twelve Gy was delivered to one side using a Theratron T-1000 Cobalt unit with the other side used as the control. Twelve weeks post injury arteriograms were performed. The animals were then sacrificed and iliac arteries explanted. Histomorphometric analysis of arterial cross sections was performed. RESULTS: Neointima formation was observed in all arteries. Unilateral thrombosis was noted in two animals. The mean neointimal thickness in the radiated and control arteries was 0.63 +/- 0.17 mm and 0.72 +/- 0.31 mm, respectively. The differences in minimal luminal diameter and the neointimal thickness between the two groups were not statistically significant. Complications included superficial hair loss in the radiation port in 4 animals, and 2 deaths prior to the completion date (1 of hemorrhagic enteritis possibly related to the radiation, and 1 of iliac rupture). CONCLUSION: External radiation at this low dose is not effective in preventing vascular restenosis following balloon injury in this animal model.

Comparison of membrane filter, multiple-fermentation-tube, and presence-absence techniques for detecting total coliforms in small community water systems.

Methods for detecting total coliform bacteria in drinking water were compared using 1,483 different drinking water samples from 15 small community water systems in Vermont and New Hampshire. The methods included the membrane filter (MF) technique, a 10-tube fermentation tube (FT) technique, and the presence-absence (P-A) test. Each technique was evaluated using a 100-ml drinking water sample. Of the 1,483 samples tested, 336 (23%) contained coliforms as indicated by either one, two, or all three techniques. The FT detected 82%, the P-A detected 88%, and the MF detected 64% of these positives. All techniques simultaneously detected 55% of the positives. Evaluation of the confirmation efficiency of the P-A technique showed 94% of the presumptive positives confirming as coliforms. Thirteen different species of coliforms were identified from the 37 tests in which the P-A was positive but the MF and FT were negative. The P-A test was simple to inoculate and interpret and was considerably more sensitive than the MF and slightly more sensitive than the FT in detecting coliforms in this type of drinking water supply.

Percutaneous creation of acute type-B aortic dissection: an experimental model for endoluminal therapy.

PURPOSE: To evaluate the feasibility of a percutaneously created type-B aortic dissection as an experimental model for percutaneous therapy. This model was used to evaluate the hemodynamic effects of single-balloon fenestration of the intimal flap. MATERIALS AND METHODS: Acute type-B dissections were created in descending aortae of 15 swine via a femoral (n = 6) or carotid (n = 9) approach. The initial subintimal tear was made with use of a Colapinto needle. The dissections were extended to a predefined position in the aorta. The proximal and distal tears were balloon dilated. The mural flap was balloon fenestrated in six animals, just above the celiac artery. Aortograms were obtained to establish the presence and extent of the dissection. Manometry was performed in both lumina to evaluate the hemodynamics of the dissected aorta and the effects of balloon fenestration in this model. Pathologic specimens were also examined. RESULTS: Creation of dissection was successful in 11 of 15 animals, with six developing true lumen narrowing (group A). The other five animals (group B) had flow in both lumina without evidence of true lumen narrowing. After the creation of a single-balloon fenestration in the group A swine, the arteriograms revealed no evidence of blood admixture between the true and false lumina, and there was no change in the intravascular pressures. Examination of the explanted aortae showed a more extensive circumferential dissection in group A animals as compared with group B. CONCLUSION: The percutaneously created acute type-B aortic dissection is a feasible model for experimentation. The hemodynamics of the aorta did not change after single-balloon fenestration in this model.