title: Drug-eluting balloon angioplasty for carotid in-stent restenosis.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cardiovascular and Neurological Department, San Donato Hospital, Arezzo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Liistro
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Simone
authors.initials: S
authors.lastname: Grotti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ventoruzzo
authors.forename: Rocco
authors.initials: R
authors.lastname: Vergallo
authors.forename: Guido
authors.initials: G
authors.lastname: Bellandi
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bolognese
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D016893:Carotid Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D057785:Catheters; D020099:Coated Materials, Biocompatible; D004359:Drug Therapy, Combination; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional; D014654:Vascular Patency
chemical_list: D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D010975:Platelet Aggregation Inhibitors; D017239:Paclitaxel