title: Drug-coated balloon dilation before carotid artery stenting of post-carotid endarterectomy restenosis.
abstract: OBJECTIVE
  To investigate if drug-coated balloon (DCB) predilation may improve the efficacy of carotid artery stenting (CAS) for restenosis after carotid endarterectomy (CEA).
  
  
  METHODS
  Eighteen consecutive patients (11 men; median age 75 years) with significant restenosis within 24 months of CEA were treated with a paclitaxel-coated DCB prior to CAS. Clinical outcomes and stent patency were systematically appraised.
  
  
  RESULTS
  All patients were successfully treated according to this clinical protocol. The only complication occurred in a patient who had a transient ischemic attack during prolonged DCB inflation. At a median follow-up of 18 months, no >50% restenosis was observed on duplex ultrasound scans; however, moderate hyperplasia at the proximal stent edge was found in 4 patients. One patient died at 9 months from a myocardial infarction.
  
  
  CONCLUSIONS
  Despite the small sample size and in keeping with the historically high risk of recurrent restenosis after CAS for CEA restenosis, this case series suggests that DCB dilation followed by CAS for postsurgical restenosis is feasible, safe, and may be associated with favorable clinical outcomes at midterm follow-up.
authors: S. Maria della Misericordia University Hospital, Udine, Italy piccoli.gianluca@gmail.com.
authors: Gianluca
authors: G
authors: Piccoli
authors: Sapienza University of Rome, Latina, Italy.
authors: Giuseppe
authors: G
authors: Biondi-Zoccai
authors: S. Maria della Misericordia University Hospital, Udine, Italy.
authors: Vladimir
authors: V
authors: Gavrilovic
authors: S. Maria della Misericordia University Hospital, Udine, Italy.
authors: Viviana
authors: V
authors: Radici
authors: S. Maria della Misericordia University Hospital, Udine, Italy.
authors: Iacopo
authors: I
authors: Cancelli
authors: S. Maria della Misericordia University Hospital, Udine, Italy.
authors: Paolo
authors: P
authors: Frigatti
authors: Sapienza University of Rome, Latina, Italy IRCCS NeuroMed, Pozzilli, Italy.
authors: Giacomo
authors: G
authors: Frati
authors: Sapienza University of Rome, Latina, Italy.
authors: Antonino G M
authors: AG
authors: Marullo
authors: S. Maria della Misericordia University Hospital, Udine, Italy.
authors: Paolo
authors: P
authors: Divis
authors: S. Maria della Misericordia University Hospital, Udine, Italy.
authors: Daniele
authors: D
authors: Gasparini
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D020099:Coated Materials, Biocompatible; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage*; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D062666:Vascular Access Devices; D014654:Vascular Patency
chemical_list: D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D017239:Paclitaxel
keywords: carotid artery disease; carotid artery stenting; carotid endarterectomy; drug-coated balloon; drug-eluting balloon; neointimal hyperplasia; restenosis