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Treating Diabetic Microvasculopathy Using Parallel, Thin Planes of X-Rays

JR Nassimi*, DC Heaney, JE Davis, CR Messina, T Zimmerman, ME Schweitzer, S Mofakham, M Bannazadeh, FA Dilmanian, Stony Brook University Hospital, Stony Brook, NY


(Sunday, 7/14/2019)  

Room: ePoster Forums

Purpose: Diabetic microvasculopathy is a disease of small vessels in diabetic patients that can lead to problems such as arterial plaques, arterial wall thickening, and blockage of blood flow. Effective treatment of diabetic microvasculopathy is currently limited to amputation. Not only do these amputations carry a high perioperative mortality rate, but the postoperative long-term mortality rates associated with these amputations are approximately 48%, 61%, and 70% at 1, 2, and 3 years, respectively. X-ray microbeam radiation therapy (MRT) could improve diabetic microvasculopathy and potentially prevent its catastrophic complications such as limb loss.

Methods: We aim to treat a pig model of diabetic microvasculopathy with arrays of parallel, thin (0.5 mm) planes of x-rays, called x-ray microbeams. Myriad studies have shown that these beam arrays are safe and can be tolerated by tissue at high doses (several hundred Gy) with no adverse effects. The concept of treating diabetic vasculopathy with MRT is based on the demonstrated vascular rejuvenation after microbeam irradiation.

Results: The hypothesis is that the high tolerance of capillary blood vessels to x-ray microbeams is caused by the ability of the vessels to rejuvenate through the forced division of the endothelial cells. In other words, the dying endothelial cells in the paths of the beam signal their neighbors on both sides to elongate, divide, and replace them, producing new endothelial cells that in turn improve the general health of the vessels. We will test this hypothesis using an endovascular pig model of ischemic myopathy from PAD, which closely relates to the collapse of the blood vessels in diabetic vasculopathy.

Conclusion: These pigs will be tested for blood flow and function before and after irradiation at several points. Tests and imaging will include histological studies, Doppler sonography, perfusion PET, Oxygen saturation in blood vessels, and physical observation of skin color.


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