Long-term Results of drug-eluting balloon angioplasty for treatment of refractory recurrent carotid in-stent restenosis

Roberto Gandini, Costantino Del Giudice, Valerio Da Ros, Fabrizio Sallustio, Simone Altobelli, Adolfo D'Onofrio, Sergio Abrignani, Erald Vasili, Paolo Stanzione, Giovanni Simonetti

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the potential role, safety, and efficacy of paclitaxel-eluting balloon angioplasty for treatment of recurrent carotid in-stent restenosis (ISR).

Methods: Among 856 consecutive patients who underwent carotid artery stenting from May 2002 to January 2008, 41 patients had a significant ISR (>80% stenosis). Of these, 9 patients (7 women; mean age 78.1±5.6 years) had recurrent ISR despite multiple endovascular treatments (3.4±0.9 interventions) within a short period of time (2-5 months). These patients were treated with drug-eluting balloon (DEB) angioplasty for neointimal hyperplasia. Imaging (ultrasound or computed tomographic angiography) was performed at 1, 3, and 6 months and yearly thereafter.

Results: Technical success was obtained in 100% of cases, with angiographic stenosis decreasing from 87%64% to 6%64% post treatment. Peak systolic velocity decreased significantly from 4.7±1.5 m/s to 0.6.60.3 m/s after the procedure. Over a mean follow-up of 36.6±2.7 months, ultrasound imaging indicated recurrent ISR in only 3 patients at 18, 25, and 32 months after DEB angioplasty, respectively. The target vessel revascularization rate was 33.3% at 36 months. No neurological or myocardial events were recorded during follow-up. One patient died at 3 months.

Conclusion: DEB may have a potential role improving outcomes of those patients treated for early recurrent carotid ISR.

Original languageEnglish
Pages (from-to)671-677
Number of pages7
JournalJournal of Endovascular Therapy
Volume21
Issue number5
DOIs
Publication statusPublished - Oct 1 2014

Keywords

  • Carotid artery stenting
  • Drug-coated balloon
  • Drug-eluting balloon
  • In-stent restenosis
  • Paclitaxel
  • Recurrent restenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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    Gandini, R., Del Giudice, C., Da Ros, V., Sallustio, F., Altobelli, S., D'Onofrio, A., Abrignani, S., Vasili, E., Stanzione, P., & Simonetti, G. (2014). Long-term Results of drug-eluting balloon angioplasty for treatment of refractory recurrent carotid in-stent restenosis. Journal of Endovascular Therapy, 21(5), 671-677. https://doi.org/10.1583/14-4715MR.1