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Erschienen in:

07.09.2023 | Original Article

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

verfasst von: Annamária Marton, Eszter Blényesi, Katalin Török, Gábor Balogh, István Gubucz, Sándor Nardai, Gábor Lenzsér, Csaba Nagy, Gábor Bajzik, József Tollár, Imre Repa, Ferenc Nagy, Zsolt Vajda

Erschienen in: Clinical Neuroradiology | Ausgabe 1/2024

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Abstract

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.

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Titel: Treatment of In-stent Restenosis of the Internal Carotid Artery Using Drug-eluting Balloons
verfasst von: Annamária Marton
Eszter Blényesi
Katalin Török
Gábor Balogh
István Gubucz
Sándor Nardai
Gábor Lenzsér
Csaba Nagy
Gábor Bajzik
József Tollár
Imre Repa
Ferenc Nagy
Zsolt Vajda
Publikationsdatum: 07.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Neuroradiology / Ausgabe 1/2024
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI: https://doi.org/10.1007/s00062-023-01343-6

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