Drug-Coated Balloons for Treatment of Internal Carotid Artery Restenosis After Stenting: A Single-Center Mid-Term...

Area of Science:

• Neuroendovascular interventions
• Vascular surgery
• Cardiology

Background:

• Endovascular and surgical treatments for extracranial internal carotid artery (ICA) stenosis carry a risk of restenosis due to endothelial hyperplasia.
• Drug-coated balloons (DCBs) are designed to mitigate neointimal hyperplasia but are infrequently used in neurovascular procedures.

Purpose of the Study:

• To retrospectively evaluate the mid-term outcomes of DCB treatment for in-stent restenosis (ISR) in the ICA.
• To analyze potential risk factors for restenosis and compare outcomes across different DCB balloon types.

Main Methods:

• Analysis of medical history, comorbidities, and periprocedural data for 109 patients treated with DCB for >50% ICA ISR post-stenting.
• Follow-up using Doppler ultrasound, with CT/MR angiography and digital subtraction angiography for validation.
• Evaluation of risk factors for restenosis and outcomes associated with three DCB balloon types.

Main Results:

• DCB treatment was performed in 109 cases with a 0.9% in-hospital major stroke rate.
• Recurrent ISR occurred in 17 patients (15.6%) at a mean of 30.2 months post-treatment.
• Tobacco use was significantly linked to a higher incidence of recurrent ISR.

Conclusions:

• DCB angioplasty is an effective treatment for ICA ISR, potentially delaying and reducing restenosis.
• Managing patient comorbidities and encouraging lifestyle changes may further aid in preventing ISR.