PDF(Pubmed)
Abstract：
We have reviewed the development and current status of therapies based on exposure to non-ionizing radiation (with a photon energy less than 10 eV) aimed at suppressing the venous neointimal hyperplasia, and consequentially at avoiding stenosis in arteriovenous grafts. Due to the drawbacks associated with the medical use of ionizing radiation, prominently the radiation-induced cardiovascular disease, the availability of procedures using non-ionizing radiation is becoming a noteworthy objective for the current research. Further, the focus of the review was the use of such procedures for improving the vascular access function and assuring the clinical success of arteriovenous fistulae in hemodialysis patients. Following a brief discussion of the physical principles underlying radiotherapy, the current methods based on non-ionizing radiation, either in use or under development, were described in detail. There are currently five such techniques, including photodynamic therapy (PDT), far-infrared therapy, photochemical tissue passivation (PTP), Alucent vascular scaffolding, and adventitial photocrosslinking. The last three are contingent on the mechanical stiffening achievable by the exogenous photochemical crosslinking of tissular collagen, a process that leads to the decrease of venous compliance. As there are conflicting opinions on the role of compliance mismatch between arterial and venous conduits in a graft, this aspect was also considered in our review.
摘要：
我们回顾了基于非电离辐射（光子能量小于10eV）的治疗方法的发展和现状，旨在抑制静脉新生内膜增生。因此避免了动静脉移植物的狭窄。由于与电离辐射的医疗用途相关的缺点，突出的是辐射诱发的心血管疾病，使用非电离辐射的程序的可用性正在成为当前研究的一个值得注意的目标。Further,本综述的重点是使用此类手术改善血液透析患者的血管通路功能并确保动静脉瘘的临床成功.在简要讨论了放射治疗的物理原理之后，当前基于非电离辐射的方法，无论是在使用中还是在开发中，进行了详细描述。目前有五种这样的技术，包括光动力疗法（PDT），远红外治疗,光化学组织钝化（PTP），Alucent血管支架，和外膜光交联。最后三个取决于组织胶原的外源性光化学交联可实现的机械硬化，导致静脉顺应性降低的过程。由于对移植物中动脉和静脉导管之间的顺应性不匹配的作用存在矛盾的观点，我们的审查中也考虑了这方面的问题。
