Prevention of intracranial in-stent restenoses: predilatation with a drug eluting balloon, followed by the deployment of a self-expanding stent
| Autor: | Elisabeth Schmid, Hans Henkes, Marta Aguilar Pérez, Hansjörg Bäzner, Zsolt Vajda, Wiebke Kurre, Thomas Güthe |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Paclitaxel medicine.medical_treatment ICAD Medizin Angioplasty/angiogram Balloon Angioplasty medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Clinical Investigation Aged Aged 80 and over Arterial intervention medicine.diagnostic_test business.industry Neurointerventions Atherosclerotic disease Graft Occlusion Vascular Stent Angiography Digital Subtraction Drug-Eluting Stents Middle Aged equipment and supplies Intracranial Arteriosclerosis Surgery Cerebral Angiography Treatment Outcome Radiology Nuclear Medicine and imaging Self-expanding stent Female Stents Radiology Cardiology and Cardiovascular Medicine business Drug eluting balloon Angioplasty Balloon Cerebral angiography |
| Zdroj: | Cardiovascular and Interventional Radiology |
| ISSN: | 1432-086X |
| Popis: | Purpose Stenting in intracranial atherosclerotic disease (ICAD) is increasingly debated, due to issues of procedural safety, technical efficacy, and in-stent recurrent stenoses (ISR). In the present study, feasibility, safety, and efficacy of angioplasty using a drug-eluting balloon (DEB) followed by the implantation of a self-expanding stent (Enterprise) were evaluated for the treatment of ICAD lesions. Methods Fifty-two patients (median age: 71 years; range: 54–86 years; male/female ratio 37:15) underwent stenting of high-grade ICAD lesions between February 2010 and November 2011 in a single center. Angioplasty using a paclitaxel coated SeQuent Please (B. Braun, Germany) or DIOR (Eurocor, Germany) coronary PTCA balloon, followed by the implantation of a self-expanding stent (Enterprise, Codman, USA) was performed in 54 lesions. Angiographic and clinical follow-up was performed at 6 and 12 weeks, 6 and 12 months, and yearly thereafter. Technical success rate, periprocedural complications, occurrence of recurrent ischemic symptoms, and the development of an ISR were analyzed. Results Angioplasty using a DEB followed by stent implantation was successfully performed in 44 (81 %) cases. DEB insertion failed in 19 % of the cases and angioplasty was finally performed using a conventional PTCA balloon. The combined procedure related permanent neurologic morbidity and mortality rate (stroke, ICH, and subarachnoid hemorrhage) at 30 days and beyond was 5 %. Angiographic and clinical follow-up were obtained in 33 (61 %) lesions in 32 patients. Recurrent stenosis was seen in one (3 %) lesion. Conclusion Angioplasty and stenting using a DEB is safe and yields encouragingly low ISR rates. Further technical developments to improve lesion accessibility are, nevertheless, mandatory. |
| Databáze: | OpenAIRE |
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