Treatment of In-stent Restenosis of the Internal Carotid Artery Using Drug-eluting Balloons.

Autor: Marton, Annamária, Blényesi, Eszter, Török, Katalin, Balogh, Gábor, Gubucz, István, Nardai, Sándor, Lenzsér, Gábor, Nagy, Csaba, Bajzik, Gábor, Tollár, József, Repa, Imre, Nagy, Ferenc, Vajda, Zsolt
Zdroj: Clinical Neuroradiology; Mar2024, Vol. 34 Issue 1, p147-154, 8p
Abstrakt: Purpose: In-stent restenosis (ISR) following internal carotid artery (ICA) stenting is relatively common with an estimated incidence of 5%. Treatment options include repeat angioplasty with conventional or drug-eluting balloons (DEB), repeat stent angioplasty and surgical intervention. Application of DEB in ISR of the coronary and peripheral arteries is an established method; however, data on DEB treatment of ICA ISR are sparse. In this work, results from a retrospective cohort of 45 patients harboring 46 ICA ISR lesions treated with DEB angioplasty are presented. Methods: Clinical, procedural and imaging data from DEB angioplasty treatment of 46 high-grade ICA ISR lesions in 45 patients, performed between 2013 and 2021 were collected. A single type of DEB (Elutax, Aachen Resonance, Aachen, Germany) was used in all procedures. Imaging follow-up was performed by regular Doppler ultrasound (DUS), verified by computed tomography angiography (CTA) in cases suspicious for a recurrent ISR. Results: Technical success was 100%. Intraprocedural and postprocedural complications were not encountered. Clinical follow-up was obtained in all patients. Recurrent stroke in the affected territory was not encountered. A recurrent ISR following DEB treatment was confirmed by DUS and CTA in 4/46 (8.7%) of the lesions and were retreated with DEB. A third recurrent ISR occurred in a single case (2%) and following a second DEB retreatment there were no signs of a fourth recurrence after 36 months follow-up. Conclusion: The use of DEB angioplasty is a safe and effective treatment of ICA ISR lesions, yielding significantly better results compared to other modalities. Randomized multicenter studies are warranted. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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