Drug-Coated Balloon Dilation Before Carotid Artery Stenting of Post–Carotid Endarterectomy Restenosis. (April 2015)

• Record Type: Journal Article
• Authors: Piccoli, Gianluca; Biondi-Zoccai, Giuseppe; Gavrilovic, Vladimir; Radici, Viviana; Cancelli, Iacopo; Frigatti, Paolo; Frati, Giacomo; Marullo, Antonino G. M.; Divis, Paolo; Gasparini, Daniele
• Is Part Of: Journal of endovascular therapy. Volume 22:Number 2(2015:Apr.)
• Page Start: 212
• Page End: 216
• Publication Date: 2015-04
• Subjects: carotid artery disease -- carotid endarterectomy -- carotid artery stenting -- drug-eluting balloon -- drug-coated balloon -- restenosis -- neointimal hyperplasia; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602815573498
• Languages: English
• ISSNs: 1526-6028

Abstract

Purpose: To investigate if drug-coated balloon (DCB) predilation may improve the efficacy of carotid artery stenting (CAS) for restenosis after carotid endarterectomy (CEA).Methods: Eighteen consecutive patients (11 men; median age 75 years) with significant restenosis within 24 months of CEA were treated with a paclitaxel-coated DCB prior to CAS. Clinical outcomes and stent patency were systematically appraised.Results: All patients were successfully treated according to this clinical protocol. The only complication occurred in a patient who had a transient ischemic attack during prolonged DCB inflation. At a median follow-up of 18 months, no >50% restenosis was observed on duplex ultrasound scans; however, moderate hyperplasia at the proximal stent edge was found in 4 patients. One patient died at 9 months from a myocardial infarction.Conclusion: Despite the small sample size and in keeping with the historically high risk of recurrent restenosis after CAS for CEA restenosis, this case series suggests that DCB dilation followed by CAS for postsurgical restenosis is feasible, safe, and may be associated with favorable clinical outcomes at midterm follow-up.