Cardiovascular and Neurological Department, San Donato Hospital, Arezzo, Italy.
J Endovasc Ther. 2012 Dec;19(6):729-33. doi: 10.1583/JEVT-12-3942R.1.
To report midterm results of 3 cases in which drug-eluting balloons (DEBs) were successfully used for the management of carotid in-stent restenosis (ISR).
Two women aged 68 and 70 years and a 68-year-old man were referred to our institution for asymptomatic severe stenosis [>80% with peak systolic velocity (PSV) >300 cm/s by Doppler ultrasound assessment] of individual Carotid Wallstents implanted in the proximal left internal carotid artery (ICA). In the angiosuite, the left ICA was engaged in a telescopic fashion with a triple coaxial system formed by a 6-F long sheath and a preloaded 5-F, 125-cm diagnostic catheter over a 0.035-inch soft hydrophilic guidewire. Under distal filter protection, the lesions were predilated using a 3.5 × 20-mm coronary balloon and then treated with two 1-minute inflations of a 4 × 40-mm Amphirion In.Pact paclitaxel-eluting balloon, followed by 3 months of dual antiplatelet therapy. At 12, 22, and 36 months, respectively, the patients are still asymptomatic, with duplex-documented stent patency at 6, 12, and 24 months, respectively.
DEBs are an emerging strategy for carotid ISR, with encouraging midterm results in these patients. Further experience in larger cohorts is needed to confirm these preliminary observations.
报告 3 例使用药物洗脱球囊（DEB）成功治疗颈动脉支架内再狭窄（ISR）的中期结果。
2 名女性患者年龄分别为 68 岁和 70 岁，1 名 68 岁男性，因无症状性严重狭窄[多普勒超声评估的狭窄率>80%，收缩期峰值流速（PSV）>300cm/s]就诊于我院，分别于左侧颈内动脉近端植入颈动脉 Wallstent。在血管造影套件中，通过 6-F 长鞘和预装 5-F、125-cm 诊断导管套叠在 0.035 英寸软亲水导丝上的三同轴系统，进行左颈内动脉（ICA）的血管内操作。在远端滤器保护下，使用 3.5×20mm 冠状动脉球囊对病变进行预扩张，然后使用 2 个 4×40mm Amphirion In.Pact 紫杉醇洗脱球囊进行 1 分钟的扩张，之后进行 3 个月的双联抗血小板治疗。分别在 12、22 和 36 个月时，患者仍然无症状，双功能超声检查分别在 6、12 和 24 个月时显示支架通畅。
DEB 是颈动脉 ISR 的一种新兴治疗策略，这些患者的中期结果令人鼓舞。需要更大的队列经验来证实这些初步观察结果。
