Recurrent carotid in-stent restenosis treated with a Paclitaxel-Eluting Balloon: case report and review of literature

• Autor(a) principal: Braga,Sandrina Figueiredo
• Data de Publicação: 2013
• Outros Autores: Brandão,Daniel, Lobo,Miguel, Brandão,Pedro, Canedo,Alexandra
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2013000400007
• topic: Carotid artery stenosis; Carotid artery stenting; In-stent restenosis; Drug-eluting balloon; Paclitaxel

Introduction: Carotid artery stenting (CAS) is a valid alternative to carotid endarterectomy with proper indications. In-stent restenosis (ISR) is a possible complication and there are multiple therapeutic options for severe ISR (>70%). The use of drug-eluting balloons (DEB) has increasing evidence as a new endovascular treatment for ISR. The authors report a case of recurrent ISR treated with a DEB. Case report: Male patient, 67 years-old, with a history of cervical radiation in 2006. In 2007, he had a stroke in the territory of the right internal carotid artery (ICA). The duplex ultrasound (DUS) showed right ICA occlusion and left ICA stenosis >70%. He underwent left CAS under fi lter protection, without complications. He was kept as an outpatient and in 2009 he presented ISR >70%. The patient was treated with re-stenting, without residual stenosis and had an uneventful course. In 2012, DUS revealed recurrent ISR >70%. Angioplasty with a paclitaxel-eluting balloon was performed, with distal cerebral protection, good imaging and hemodynamic results and an uneventful course. At 6 months of follow-up, the patient has no complications and no ISR documented by ultrasound. Conclusions: The use of DEB in the treatment of ISR after CAS is an emerging strategy with promising results.