title: Neurovascular in-stent stenoses: treatment with conventional and drug-eluting balloons.
abstract: OBJECTIVE
  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.
  
  
  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: Klinik für Neuroradiologie, Bürgerhospital, Klinikum Stuttgart, Germany.
authors: Z
authors: Z
authors: Vajda
authors: T
authors: T
authors: Güthe
authors: M Aguilar
authors: MA
authors: Perez
authors: A
authors: A
authors: Heuschmid
authors: E
authors: E
authors: Schmid
authors: H
authors: H
authors: Bäzner
authors: H
authors: H
authors: Henkes
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000601:surgery*; D003131:Combined Modality Therapy; D054855:Drug-Eluting Stents; D005260:Female; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011859:Radiography; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage
chemical_list: D050257:Tubulin Modulators; D017239:Paclitaxel