BACKGROUND AND PURPOSE: ISRs remain a major issue in the endovascular management of ICAD, requiring retreatment by reangioplasty. The aim of the present study was to evaluate the technical feasibility, safety, and efficiency of the novel DEBs for neurovascular ISRs. MATERIALS AND METHODS: Fifty-one patients (median age, 67 years; age range, 34-82 years; male/female ratio, 37:14) underwent 63 balloon dilation procedures for ISRs in intracranial stented arterial segments between November 2007 and August 2010 in a single center. Of the 63 procedures, 20 (32%) were performed by using a conventional balloon and 43 (68%), by using a paclitaxel-eluting balloon (SeQuent Please). Angiographic and clinical follow-up was performed at 6 and 12 weeks, 6 and 12 months, and yearly thereafter. Technical success rate, periprocedural complications, occurrence of recurrent ischemic symptoms, and the development of a recurrent ISR after reangioplasty were analyzed. RESULTS: Technical success, defined as <50% residual stenosis was achieved in all cases (100%), with failure of the DEB treatment in 6% of the attempts; those lesions were finally successfully treated with a conventional balloon. The combined permanent neurologic morbidity and mortality rate (stroke, ICH, and SAH) at 30 days was 1.6%. Substantial difference was found in the rate of recurrent stenosis when comparing conventional balloons and DEBs, with recurrent stenosis rates of 50% and 9%, respectively. CONCLUSIONS: The initial results of reangioplasty of intracranial ISRs with DEBs are encouraging; further technical developments are, nevertheless, mandatory.
BACKGROUND AND PURPOSE: ISRs remain a major issue in the endovascular management of ICAD, requiring retreatment by reangioplasty. The aim of the present study was to evaluate the technical feasibility, safety, and efficiency of the novel DEBs for neurovascular ISRs. MATERIALS AND METHODS: Fifty-one patients (median age, 67 years; age range, 34-82 years; male/female ratio, 37:14) underwent 63 balloon dilation procedures for ISRs in intracranial stented arterial segments between November 2007 and August 2010 in a single center. Of the 63 procedures, 20 (32%) were performed by using a conventional balloon and 43 (68%), by using a paclitaxel-eluting balloon (SeQuent Please). Angiographic and clinical follow-up was performed at 6 and 12 weeks, 6 and 12 months, and yearly thereafter. Technical success rate, periprocedural complications, occurrence of recurrent ischemic symptoms, and the development of a recurrent ISR after reangioplasty were analyzed. RESULTS: Technical success, defined as <50% residual stenosis was achieved in all cases (100%), with failure of the DEB treatment in 6% of the attempts; those lesions were finally successfully treated with a conventional balloon. The combined permanent neurologic morbidity and mortality rate (stroke, ICH, and SAH) at 30 days was 1.6%. Substantial difference was found in the rate of recurrent stenosis when comparing conventional balloons and DEBs, with recurrent stenosis rates of 50% and 9%, respectively. CONCLUSIONS: The initial results of reangioplasty of intracranial ISRs with DEBs are encouraging; further technical developments are, nevertheless, mandatory.
Authors: Rishi Gupta; Firas Al-Ali; Ajith J Thomas; Michael B Horowitz; Thomas Barrow; Nirav A Vora; Ken Uchino; Maxim D Hammer; Lawerence R Wechsler; Tudor G Jovin Journal: Stroke Date: 2006-09-07 Impact factor: 7.914
Authors: Gunnar Tepe; Thomas Zeller; Thomas Albrecht; Stephan Heller; Uwe Schwarzwälder; Jean-Paul Beregi; Claus D Claussen; Anja Oldenburg; Bruno Scheller; Ulrich Speck Journal: N Engl J Med Date: 2008-02-14 Impact factor: 91.245
Authors: Marc I Chimowitz; Michael J Lynn; Harriet Howlett-Smith; Barney J Stern; Vicki S Hertzberg; Michael R Frankel; Steven R Levine; Seemant Chaturvedi; Scott E Kasner; Curtis G Benesch; Cathy A Sila; Tudor G Jovin; Jose G Romano Journal: N Engl J Med Date: 2005-03-31 Impact factor: 91.245
Authors: A S Turk; E I Levy; F C Albuquerque; G L Pride; H Woo; B G Welch; D B Niemann; P D Purdy; B Aagaard-Kienitz; P A Rasmussen; L N Hopkins; T J Masaryk; C G McDougall; D Fiorella Journal: AJNR Am J Neuroradiol Date: 2007-11-07 Impact factor: 3.825
Authors: Yvonne P Clever; Bodo Cremers; Wolfgang von Scheidt; Michael Böhm; Ulrich Speck; Bruno Scheller Journal: Clin Res Cardiol Date: 2013-09-26 Impact factor: 5.460
Authors: Franz X Kleber; Harald Rittger; Klaus Bonaventura; Uwe Zeymer; Jochen Wöhrle; Raban Jeger; Benny Levenson; Sven Möbius-Winkler; Leonhard Bruch; Dieter Fischer; Christian Hengstenberg; Tudor Pörner; Detlef Mathey; Bruno Scheller Journal: Clin Res Cardiol Date: 2013-08-28 Impact factor: 5.460